Buckwheat,

From what I know of this, they changed the name to reflect the fact that nobody really has a clue what causes this stupid disease. The name "reflex sympathetic dystrophy" assumes a cause---dysfunction of the sympathetic nervous system. While that most likely plays a role in the underlying pathophysiology of the disease, it's irresponsible to assume that it's the direct cause when doctors now suspect that there are more factors at play.

As for how they can treat without knowing the cause, the answer is pretty simple: trial and error. The truth is that the cause of most diseases are unknown. The only diseases that doctors can really claim to understand are infectious diseases, and even then the workings of the immune system can be a bit of a mystery. Nobody knows what really causes things like cancer or heart disease either...it's the same as with RSD. Why does one person get it and not another? The answer is too complex to fully understand right now---a combination of genetic and environmental factors are likely, but so little is still known about genetics!

I've had lots of interesting discussions on this with doctors. One doctor in particular discussed it with me ad nauseum. It was one of my grandpa's favorite rants...about how medicine had advanced so far since his days in medical school, yet the understanding of disease had remained essentially the same for those 50 years.

-Betsy