They cause deep aching, bilateral cramping pain in the thigh or calf usually in the evening or during the night, which responds to massage and analgesia. Physical and laboratory exams are negative. The child may have constant fatigue, disturbed sleep patterns, anxiety and depression. Arthritis does not occur, and the child may appear otherwise healthy. The pain is very real, but not caused by a serious underlying disease.
Treatment consists of a combination of exercise and pain medication.
Children and adolescents with RSD have a history of constant pain and increasing disability in the distal part of an extremity that is exacerbated by even mild activity. The involved extremity may have diffuse swelling, tenderness, coolness, and mottling. Even slight touch may cause severe discomfort, and attempts to move the limb are extremely painful. Treatment includes pain control to allow physical therapy of the affected limb. A psychologist may be needed to assist the child in pain control or desensitization.