Four Stages Of R.S.D.
STAGE I
  1. Onset of severe, burning pain closely limited to the site of injury
  2. Hyperesthesia
  3. Localized oedema
  4. Muscle spasm
  5. Stiffness and limited mobility
  6. Vasospasms; at onset skin is usually warm, red and dry and then changes to cyanotic, cold and sweaty
  7. Average duration of Stage 1 is 3 months. In mild cases this stage lasts a few weeks, then subsides spontaneously or responds rapidly to treatment
  8. Hyperhidrosis

 

STAGE II
  1. Pain becomes even more severe and more diffuse
  2. Oedema spreads and changes from a soft to a brawny type
  3. Hair becomes scant, nails become brittle, cracked and heavily grooved
  4. Spotty osteoporosis occurs early but may become severe and diffuse
  5. Increased thickness of the joint
  6. Muscle wasting
  7. Stage II may last from 3 to 6 months
 

STAGE III
  1. Marked trophic changes eventually become irreversible
  2. For many patients the pain becomes intractable and may involve the entire limb
  3. Atrophy of the muscles
  4. Interphalangeal and other joints of the foot or hand have become extremely weak; have limited motion and may finally become ankylosed
  5. Contraction of flexor tendons occurs and occasionally subluxations are produced
  6. Bone deossification has now become marked and diffuse

 

STAGE IV

Not all agree on the existence of a FOURTH Stage. Basically, it is two years or more post-onset. At this stage the RSD is not likely to be effectively treated with blocks as the percentage of SIP (Sympathetically Independent Pain) is now much greater than the percentage of SMP (Sympathetically Mediated Pain), meaning the majority of the pain signals are now originating in the brain and not at the original RSD site where a local block would help.

A small percentage of patients have developed generalized RSD affecting the entire body.