Management of reflex sympathetic dystrophy

Reflex sympathetic dystrophy (RSD) is currently defined as CRPS type I (com plex regional pain syndrome). Due to the lack of comprehensive understandin g of underlying pathophysiological mechanisms, a wide variety of therapeuti c approaches are proposed, all of them being of unpredictable and variable efficacy. This is also due to the lack of controlled studies and randomized therapeutic trials. Most of the so-called "efficient" treatments are in fa ct based on anecdotal case reports and/or uncontrolled studies with small n umber of cases. Sympathetic blocks and active physiotherapy are, for many a uthors, the cornerstones of the efficient management. The role of preventio n must be strongly emphasized, focusing, if RSD occurs following surgery, o n the importance of pre- and postoperative efficient analgesia.