PSYCHOLOGICAL CHARACTERISTICS OF REFLEX SYMPATHETIC DYSTROPHY VERSUS MYOFASCIAL PAIN SYNDROMES

Background and Objectives. Reflex sympathetic dystrophy (RSD) has some times been hypothesized to derive from a unique psychological predispo sition because of its enigmatic features, as well as the profound beha vioral and emotional characteristics manifested by some patients. This study compares the psychological characteristics of RSD and myofascia l pain syndrome (MPS) patients to discern the extent of any aspects un ique to RSD. Methods. The patients included 58 with RSD and 214 with M PS, all of whom completed the Minnesota Multiphasic Personality Invent ory (MMPI) as well as a pain questionnaire. Additional pertinent demog raphic and clinical characteristics were ascertained. Results. The onl y significant demographic group differences revealed a higher proporti on of RSD patients not working (P <.05) and a higher proportion of RSD patients receiving Workers' Compensation payments (P <.001). The RSD patients had shorter duration of pain (P <.01) and were taking fewer p ain medications (P <.01) than the MPS group, but the two groups had co mparable numbers of pain-related surgeries, pain intensity ratings, pe rceived ability to cope, and ongoing extent of involvement in social o r recreational activities. A wide range of functioning was in evidence for both groups on the MMPI clinical scales, but with duration as a c ovariate, the RSD group had significantly (P <.05) lower scores on the hypochondriasis, depression, hysteria, and psychasthenia scales and h igher scores on the hypomania scale. The duration covariate was signif icant (P <.05) only for the infrequency (rare responses) and depressio n scales. Duration and certain scale scores were inversely correlated. Conclusions. With only a few exceptions, RSD and MPS patients appear comparable with respect to a wide range of demographic, clinical, and psychological functioning indices. A specific psychological profile, u niquely neurotic or otherwise, has yet to be demonstrated in terms of any etiologic or maintenance factors in RSD.