[QUOTE=overthehill;547562]Hi!

I don't understand anatomy very well, but I'm wondering if when you have RSD, is the entire sympathetic nervous system comprised?

Inbetween these two surgeries, I developed Major Depression and Anxiety Disorder, which started to get better with medication and psycho-therapy; but the dx. of RSD again made it worsen.

I was also just dx'd with Fibromyalgia. Is this too, a deficiency in the Sympathetic Nervous System, or possibly the Central Nervous System?

Good morning overthehill.

RSD is a very confusing disease, even to the Doctors who are experienced with it. It is not a deficiency but a dysfunction not just of the sympathetic system but, eventually, of the entire nervous system.

Understanding what goes on with the nervous system, including the brain, has helped me a lot in dealing with RSD.
It's been a while since I have studied the effects RSD has on the nervous system but here is some of what I remember, in general terms.

The body does not feel pain, it only sends signals to the brain and the brain interprets the signals according to which nerves send the signals. Different nerves terminate in different ares of the brain; it's like a switchboard receiving electrical signals over wires. The brain tells us that we are in pain.

In RSD, nerve fibers in layers 1 and 2 will, after a while, grow new nerve fibers called sprouts into layers 5 and 6 of the spinal cord which then connect with nerves there and allow the RSD to spread to other parts of the body affecting circulation and motor function there. These signals are now shorted to nerves coming from parts of the body that have nothing wrong with them but, the brain does not know that there is nothing wrong in those parts. The brain only knows that a signal was received that indicates an injury and it causes the immune system to react and send the usual repair crew to the perceived site of the injury. That is how swelling and inflammation happens at sites remote from the original injury; the RSD has spread.

Pain and the brain.

All nerve signals have the same amplitude (strength).
The intensity of the signal is determined by the frequency of the signal, how often it is sent. Mild pain means a low frequency signal train, severe pain means a high frequency signal train. The higher the frequency the more severe the pain.


The brain.



The brain is plastic.

The brain is changing all the time. Neurons die and neurons are born as we experience and forget.

I think of the brain as having different networks for different tasks and sensations.
These networks are weakened or strengthened according to how often and how strongly they are stimulated. The two networks that concern us with RSD are the pain network and the pleasure network. When we are in pain, we find it difficult to impossible to feel pleasure and the pleasure network, getting little or no stimulation, weakens and starts to die off. The pain network, being stimulated constantly and strongly starts to grow new neurons and sends out new sprouts that connect back to other neurons in the pain network forming a feedback loop that is similar to an electronic oscillator. The pain has become self perpetuating.

In order to reduce the pain network in size, we would have to stop the pain and increase the pleasure so that the pleasure network will grow again and the pain network will shrink. Narcotic pain medication seems to be the only way to reduce the pain for most people. For myself, not having had access to narcotics, acceptance and making friends with the pain was the way.

Once the pain is, either accepted as a normal part of life or, reduced through narcotic pain medication, we can start to feel pleasure again and that pleasure will grow the pleasure network and decrease the pain network.

The real story is, of course, much more complicated and involves many chemical neuro transmitters and hormones and one would have to be a neuro biologist to really understand it but, I have benefited a great deal from thinking of RSD in those terms.

Physical activity is, of course, very important to living with RSD.

There you have my take on RSD overthehill.
I am always happy to talk more about the subject if you or anyone else is interested.

Have a good day and don't ever lose hope.
We may not be able to find a cure but, we can still have a good life even with RSD.

woodsman