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What is ‘RSD’ (Reflex Sympathetic Dystrophy)?

If you've been injured in an accident or on the job, the attorneys of Hach & Rose, LLP have the knowledge, skills, and experience required to hold the party responsible for your injury accountable.

Last Updated: 09-14-2023

Reflex Sympathetic Dystrophy (RSD) is a chronic pain that can develop after someone sustains an injury. RSD is often diagnosed and used almost synonymously with ‘complex regional pain syndrome,’ ‘Subdeck’s atrophy,’ and ‘causalgia,’ making it even more confusing to legal and medical practitioners. Although RSD is a poorly understood condition and is frequently misdiagnosed, it is a condition that causes significant pain and discomfort. Often, it can completely disable the victim. The symptoms can spread throughout your entire body if you are afflicted with this syndrome. While some signs and symptoms can lead to a diagnosis of RSD, such as radiating pain, numbness or tingling, and extreme sensitivity to touch, the condition is difficult to diagnose.

Although many events can lead one to develop RSD (such as heart disease, degenerative cervical arthritis, stroke, shingles, and breast cancer, and the list goes on), we at Hach & Rose, LLP have become quite familiar with injuries related to traumatically-induced and surgically-induced RSD.

RSD can impair your everyday activities, prevent you from working, and hamper your participation in social and recreational activities. You may need pain medication and various medical procedures like spinal stimulators and pain pumps just to be able to cope with the pain. RSD sufferers often deal with depression and mental anguish due to unbearable pain. It is a very serious, life-changing affliction.

RSD is not a condition that affects a tremendous portion of the population, but it is important to mention it due to the high frequency with which it is misdiagnosed and misunderstood. Hiring an attorney who does not understand RSD’s symptoms and debilitating nature will make it impossible to obtain the compensation justified when a client is diagnosed or misdiagnosed with the condition. 
There are many places to obtain information on RSD via the internet; a few places to start are:

  • Reflex Sympathetic Dystrophy Syndrome Association: www.rsds.org provides information about the disease and regular updates on treatment options, and other information about their organization dedicated solely to those afflicted with RSD.
  • To gain further knowledge of the condition, go to www.arthritis.com, and search for ‘RSD’ on that site. It will provide everything from what to expect from the disease to treatment options.
  • Further searches via the internet will help you understand the disease, its causes, treatment options, and support group information. Be cautious of misleading groups set up by law firms to obtain clients via the Internet. Be careful if an attorney or someone else recommends an attorney online. This is, unfortunately, a common practice among unscrupulous attorneys looking for possible clients. They will sometimes use a ‘go-between’ that will contact you under the auspices of helping you, but their only intention is to get you to sign up with their attorney.


Unfortunately, there are no simple tests to diagnose RSD. Furthermore, RSD is often missed or misdiagnosed. Sometimes RSD sufferers are told by their doctors that they have fibromyalgia because the disorders have similar symptoms. Other times, patients are told their pain is all in their heads. This is why it’s critical that you find a doctor who is highly skilled in recognizing and diagnosing RSD.

Doctors often don’t know that RSD causes a patient’s pain until they have had it for an extended period. If you have pain that does not go away or is more serious than it should be for the type of injury you sustained, this could be the first sign of RSD. Because there are no tests, a doctor will rely on a physical exam and your medical history.

Symptoms of RSD

RSD is more common in women than in men and tends to strike around the age of 40, according to the National Institute of Neurological Disorders and Stroke. In more than 90% of RSD cases, the condition is triggered by an injury or trauma. However, the exact causes of RSD are not yet fully known. Common triggers include sprains, strains, fractures, soft tissue injuries, surgical procedures, and incorrectly placed injections.

RSD, which can affect any part of the body, can exhibit a wide variety of symptoms, including but not limited to:

  • Deep pain – typically aching, cold, or burning
  • Discoloration of skin
  • Hot and cold sensation
  • Changes in nail and hair growth patterns
  • Changes in skin texture
  • Increased sensitivity to touch
  • Swollen and stiff joints
  • Limited range of motion
  • Abnormal sweating in the affected area
  • Muscle strength loss
  • Increased loss of mobility of affected body part
  • Muscle spasms
  • Differing internal body temperatures
  • Irritability
  • Confusion
  • Memory disruptions

The onset of these symptoms may be rapid or gradual. The main three stages of RSD symptoms are as follows:

  • Acute stage. This stage can last from two months to six months. It generally involves pain, burning, flushing, sweating, swelling, cramps, stiffness, and tenderness. An X-ray can show changes in bone thinning.
  • Dystrophic stage. This stage can last six to twelve months. Pain becomes more severe. Swelling tends to spread, and it may go from a soft to a hard type. Hair may become coarse. Nails may grow faster, then slower, and become brittle and cracked. The wasting of bone may become more severe. Muscle wasting also begins during this stage.
  • Atrophic stage. This stage may be long-standing and entail a loss of motion and function of the affected limb and thinning of the fatty layers under the skin. An X-ray can show significant osteoporosis. A small percentage of people develop RSD that affects the entire body. Some patients never progress to the atrophic stage.

Treatments for Reflex Sympathetic Dystrophy

Common medications for RSD include:

  • Anesthetic creams
  • Anti-inflammatory drugs
  • Corticosteroids to treat swelling
  • Opioids, including morphine, oxycodone, hydrocodone, and fentanyl
  • Over-the-counter drugs like ibuprofen for pain
  • Antidepressants
  • Anti-seizure medications
  • Nasal spray that treats bone loss

Other therapies and treatments for Reflex Sympathetic Dystrophy include:

  • Heat therapy. Applying heat may provide relief of discomfort and swelling.
  • Physical or occupational therapy. Light and guided exercise of the affected limbs or modifying daily activities could help reduce pain and improve strength and range of motion.
  • Mirror therapy. This therapy uses a mirror to help trick the brain. Sitting before a mirror, you move the healthy limb so that the brain perceives it as the limb affected by RSD. Research indicates this therapy may improve function and reduce pain for RSD patients.
  • Transcutaneous electrical nerve stimulation (TENS). Severe chronic pain can be eased by applying electrical impulses to nerve endings.
  • Biofeedback. Learning biofeedback techniques could help. With this treatment, you learn to become more aware of your body to relax and relieve pain.
  • Spinal cord stimulation. Tiny electrodes are inserted along your spinal cord. A small electrical current is then delivered to the spinal cord, reducing pain.
  • Intrathecal drug pumps. Drug pumps are used to send pain medication into the spinal fluid.
  • Acupuncture. Inserting thin needles may help stimulate nerves and muscles to increase blood flow and relieve pain.
  • Sympathetic nerve blocks. Placing an anesthetic next to the spine to block the sympathetic nerves can relieve pain.
  • Surgical sympathectomy. This technique destroys the nerves involved in RSD. Some argue it has a favorable outcome, while others say it worsens RSD. The technique is recommended only for people whose pain is significantly but temporarily relieved by sympathetic nerve blocks.

ICD-9-CM Codes for Complex Regional Pain Syndrome (CRPS)

The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) is the official system of assigning codes to diagnoses in hospitals throughout the United States.

Complex regional pain syndrome 355.9

Type I 337.20
  • lower limb 337.22
  • specified site NEC 337.29
  • upper limb 337.21
Type II
  • lower limb 355.71
  • upper limb 354.4

Dystrophy 783.9

sympathetic (posttraumatic) (reflex) 337.20

  • lower limb 337.22
  • specified site NEC 337.29
  • upper limb 337.21



  • Central 338.0
  • Chronic 338.4
  • Complex regional 355.9
Type I 337.20
  • Lower limb 337.22
  • Specified site NEC 337.29
  • Upper limb 337.21
Type II
  • Lower limb 355.71
  • Upper limb 354.4
  • myelopathic 338.0
  • thalamic (hyperesthetic) 338.0

Seeking Maximum Compensation for Clients

The key to recovering maximum compensation for RSD is proving that the condition is directly related to your accident. The highly skilled and compassionate New York RSD injury lawyers at Hach & Rose, LLP have proven their ability to do that. Because RSD cases are sometimes difficult to diagnose, we work with medical experts who can closely evaluate your symptoms and how they relate to your accident. Our attorneys can then build a case that adequately demonstrates your challenges as an injured victim and your need for maximum compensation.

The Importance of Hiring a New York Reflex Sympathetic Dystrophy Injury Attorney

Our firm has become increasingly adept at and is recognized as a leader in representing clients diagnosed with and suffering from Reflex Sympathetic Dystrophy. We are proud to have a track record of multimillion-dollar results for RSD victims in New York. Our results include an award of more than $6 million, the highest verdict ever obtained for a victim of RSD in Orange County, New York.

Other notable results include a $3.2M settlement for a client suffering from RSD after a construction site fall, a $3.5M settlement for a union construction worker injured when a piece of sheetrock struck him on the head, and a $2.2M settlement for a woman who sustained RSD after she tripped and fell. We also secured a $900,000 settlement for a worker injured and later suffered from RSD. These are just some of the notable results that Hach & Rose has achieved on behalf of their clients who have suffered from RSD.

If you are suffering from RSD following an injury, you must seek help from a lawyer who understands this condition’s symptoms and debilitating nature. You may have a case if you have been diagnosed with RSD and believe it originated from an injury you sustained because of someone else’s negligence. At Hach & Rose, LLP, we will seek the full and fair compensation you deserve, whether you were diagnosed or misdiagnosed with RSD.

Contact Us

Contacting the New York personal injury lawyers at Hach & Rose, LLP immediately can significantly increase your chance of recovering compensation. Personal injury cases in New York have a statute of limitations of three years, so you must file your claim within three years of getting diagnosed with RSD. If you have been injured at work and your work injury has resulted in RSD in the affected body part, you could qualify for New York workers’ compensation benefits. Our legal team will be able to determine if you have a personal injury or a workers’ comp claim, or both, and then seek the compensation you deserve. Call Hach & Rose, LLP today at (212) 779-0057 to set up a free and confidential consultation.

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