Acupuncture and reflex sympathetic dystrophy

The term ''reflex sympathetic dystrophy'' (RSD) is used for various syndromes, e.g. posttraumatic edema, shoulder-hand syndrome, algodystrophy and causalgia. The clinical symptoms of RSD are characterized by a triad of autonomic, sensory and motor disturbances, which usually develop in the distal region of an affected extremity. The main symptoms are swelling a side difference in skin temperature (autonomic symptoms), reduced active movements and muscular strength (motor symptoms) and spontaneous, deep, diffuse pain with an orthostatic component (sensory system). As soon as possible the treatment of RSD should include sympatholytic strategies and obligatory physical therapy. Acupuncture has also been reported to reduce sympathetic activity. The analgestic effect of acupuncture is well known, and therefore from an at least theoretical point of view, it should make sense to use acupuncture in the treatment of RSD. To date, however, no prospective, randomized, controlled, clinical long-term studies have been done. One short-term study showed promising results, but did not reach statistical significance. In that study acupuncture treatment seemed to alleviate the major symptoms of RSD. Since acupuncture rarely has side effects, its role as an additional option in the treatment of RSD should be further investigated.