Bonica coined the term reflex sympathetic dystrophy in 1953. The American Association of Hand Surgery proposed changing the name to sympathetic maintained pain syndrome, and a consensus expert panel recommended a change to complex regional pain syndrome. Emergency physicians are frequently in a position to identify the problem and may play a significant role in minimizing impact of this common entity. Schwartzmann states that a common mechanism may be injury to central or peripheral neural tissue. Roberts proposes that sympathetic pain results from tonic activity in myelinated mechanoreceptor afferents.
Input causes tonic firing in neurons that are part of a nociceptive pathway.
Campbell et al propose a hypothesis that places the primary abnormality in the peripheral nervous system. All agree that, regardless of mechanism, the patient experiences intense burning pain in one or more extremities. Schwartzmann says that RSDS usually occurs secondary to fractures, sprains, and trivial soft tissue injury. While some cases are associated with an identifiable nerve injury, many are not. In and of itself, the disease is not fatal.