The process of evaluating treatment for RSD is not an easy task. The severe chronic pain is a major focus for the patient, but the physician must consider the overall health of the patient and any secondary medical conditions that require treatment. Chronic pain is understood to be a persistent pain that frequently is not amenable to routine pain control methods. It can develop when pain lasts longer than is expected for a trauma or injury. Because there are many differences in what is regarded as chronic pain, management strategies remain flexible and related to specific cases.
Chronic pain can have mixed or unknown mechanisms or it can be psychological in nature.
The selection of an appropriate analgesic medication can be difficult. If the pain is still not controlled, stronger opioids such as morphine, hydromorphone, and methadone can be used. For patients who still do not achieve adequate pain control, it may be necessary at this point to consider adjuvant analgesic therapy. Adjuvant agents are not typically thought of as having analgesic properties. If a physician does not have a conclusive diagnosis of what is causing the chronic pain or it is unclear if it is nociceptive, neuropathic or a mixed classification of chronic pain, it may take a trial of several different medications to find those that are helpful in treating each patient.