Early treatment often results in remission. If treatment is delayed, however, the disorder can quickly spread to the entire limb and changes in bone and muscle may become irreversible. In 50 percent of RSDS cases, pain persists longer than 6 months and sometimes for years. Injection of a local anesthetic, such as lidocaine, is usually the first step in treatment. Injections are repeated as needed.
Surgical sympathectomy involves cutting the nerve or nerves, destroying the pain almost instantly.
But surgery may also destroy other sensations as well. Doctors now believe that treatment of RSDS usually remedies the psychological and emotional problems that are often experienced by RSDS patients. RSDS has many of the same features as causalgia, such as severe burning pain that is aggravated by physical or emotional stimuli. Investigators are studying new approaches to treat RSDS and intervene more aggressively after traumatic injury to lower the patient's chances of developing the disorder. Using a technique called microneurography, these investigators are able to record and measure neural activity in single nerve fibers of affected patients.