Neurological Associates

Pain Management Center

Vero Beach, Florida



H. Hooshmand, M.D.






( Epilepsy, Pain, MS) 

An International Referral Center dedicated to Treatment, Education and Research

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Chronic Pain: Reflex Sympathetic Dystrophy Prevention and Management

CRC Press, Boca Raton, Florida

H. Hooshmand, M.D.


History of Reflex Sympathetic Dystrophy

Year Author Contribution
1700 Potts Burning pain and atrophy in injured extremity
1813 Denmark Amputation for treatment of pain
1853 Bernard Role of sympathetic system in temperature control
1878 Bernard Role of sympathetic system in sustaining the balance of internal environment (Mileu Interne)
1864 S. Weir Mitchell Erythromelalgia
1867 S. Weir Mitchell Causalgia
1882 Volkmann Posttraumatic bone rarefaction: "acute atrophy of bone"
1898 Destot Singular osteoporosis due to longstanding sprained ankle
1900 Sudek Atrophy and bone rarefaction secondary to nerve damage
1901 Santorio Thermoscope
1908 Bier The first regional block
1916 Leriche Sympathectomy
1923 Orbeli Antifatigue effect of sympathetic nerves (Orbeli effect)
1926 Leriche Sympathetic nerve roots dysfunction as cause of pain
1926 Barré Barré-Lieou syndrome, cervical pathology involving sympathetic nerves surrounding vertebral arteries causing vertigo, blurred vision, and pain in the arms
1928 Lieou Sympathetic involvement in cervical spine pathology (Barré-Lieou syndrome)
1929 Zue Verth Peripheral acute trophoneurosis
1931 Morton and Scott Traumatic angiospasm
1932 Hisey Brain as an endocrine gland (controlling ovulation)
1933 Fontaine and Herrmann Posttraumatic osteoporosis and bone rarefaction
1934 Lehman

Traumatic vasospasm

1937 DeTakats Reflex dystrophy
1940 Homans Minor causalgia (in contrast to Mitchell's major causalgia)
1940 Ray and Wolff Trigeminal nerve role in cranial vascular headache
1943 Livingston Vicious circle of inactivity and pain resulting in RSD
1947 Steinbrocker 1. Reflex neurovascular dystrophy

2. Shoulder-hand syndrome with atrophy of hands as a common form of RSD

1947 Evans The syndrome of reflex sympathetic dystrophy (RSDS)
1947 Nathan Multiple level input of pain to the spinal cord in RSD (mitigating against surgery): wide dynamic range (WDR)
1948 Sunderland

Perpetuation of pain and RSD at spinal cord level: "turbulence phenomenon"

1955 Mitchell Sympathetic preganglionic cell bodies in all levels of spinal cord
1957 Tracey Postsympathectomy pain (also called sympathalgia pain to the spinal cord in RSD) mitigating against surgery
1964 Weirtz-Hoessels Paresis and weakness of extremity due to RSD
1970 Akil SIA (stress-induced analgesia) in rats achieved by endorphines
1971 Melzack Biasing mechanism of pain in CNS perpetuating RSD pain
1971 Goldstein Discovered opiate receptors in the brain
1973 Kleinert "Variable pain syndrome" as symptoms of RSD
1973 Duensing Thermography in nerve injuries
1973 Bonica Comprehensive 3-stage classification of RSD; early diagnosis critical in outcome of treatment
1973 Patman Mimocausalgia
1974 Hannington-Kiff Gaunethidine regional block with up to 80% relief
1975 Lichtenstein Loss of vascular tone, vasodilation, and bone resorption
1976 Wallin Hyperpathic (sympathetic) pain is different from somatic pain; injection of sympathetic amines induces hyperpathic pain in causalgic limb but not in normal limb
1976 Kozin Bilaterality in RSD; bone scan
1976 Travell Defined trigger points and trigger point injections in management of RSD
1979 Moskowitz Role of trigeminovascular structure in vascular headache
1981 Kozin Diagnostic value of scintigraphy, abnormal in 60% of RSD patients
1983 Poplawski "The most important factor in predicting improvement was ... less than 6 months between onset of RSD and the administration of therapy"
1984 Basbaum Descending analgesic endorphin system from periaqueductal gray to spinal cord
1986 Ochoa ABC phenomenon (angry backfiring c fibers as a source of pain and RSD
1986 Uricchio Thermography in radiculopathy
1988 Roberts Role of peripheral nervous system and CNS in pathophysiology of causalgia
1988 Wexler Standardized thermography and its use in RSD
1988 Hobins "Reflex sympathetic Dysfunction"
1989 Yokota Motor paresis and movement disorder due to efferent manifestation of RSD
1990 Schwartzman Movement disorders due to RSD
1991 Stein Peripheral release of lymphocyte-mediated endorphin originates an analgesic system that is in effect in all levels of CNS and PNS

The material on the Neurological Associates Pain Management Center Homepage and all it's associated, linked or reference pages is for informational and education purposes. It is not meant to take the place of your physician. Before starting, changing, or stopping any treatments or medicines consult your physician. H. Hooshmand, M.D., Neurological Associates Pain Management Center and Associates will not be held liable for any damage or loss as a result of information provided on this page or associated documentation. Again, this WEB SITE is simply published as an information source and should not be used to treat or make judgments on RSD/CRPS. All associated material on this web site may not be copied, reproduced or quoted without expressed written permission from the owner; Copyright ©1999-2014 H. Hooshmand, M.D.

Please note: This is the official Neurological Associates Pain Management Center Website. We are neither affiliated nor associated with any other website that use our name.

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This page was last updated on 3/29/2002.

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