During the first stage, which lasts approximately one to three months, the affected area is warm from vasodilatation, but then becomes cold and cyanotic from vasoconstriction. Sympathetic stimulation of sweat glands and hair follicles result in profuse perspiration and excessive body hair. Edema in the affected area may be pitting or non-pitting. The patient will complain of stiffness and muscle spasms. The second stage is marked by skin changes, such as scaling and a shiny, brawny appearance due to the loss of normal fine wrinkling.
Nails become brittle and cracked.
Muscles develop more severe spasms and atrophy. In the third stage changes become irreversible and may even spread. If a hand is involved, the part may be transformed into a claw-like extremity. A common, consistent complaint during all stages is constant, intense, burning, pain. Severe discomfort causes the patient to possessively guard the affected part and to avoid movement.