While Reflex Sympathetic Dystrophy Syndrome often affects the hand or foot, the disorder may also involve the knee, hip, shoulder or other sites. Thus, if it begins in a hand, it may continue up the arm into the shoulder. Reflex Sympathetic Dystrophy Syndrome is generally divided into three stages of progression. In the initial stage, the patient feels extreme or lingering pain, usually burning in nature. The pain most often begins in the hand or foot, but it isn't unusual for the pain to be in the hand and shoulder of the same arm or in the foot and knee of the same leg.
Some patients experience changes in the temperature and color of the skin at the affected area.
Some report rapid hair and nail growth. Most lose the ability to move affected joints normally. In the second stage of Reflex Sympathetic Dystrophy Syndrome, the patient's pain is often exacerbated by changes in temperature, air conditioning or breezes, or even by a light touch. The skin at the affected area becomes cool to the touch, and the nails become brittle. Often the spreading pain causes muscle spasms.