Hi all--its been a while for me...this is very interesting. After the discussion re ischemia/cyanosis here, I went back through my pain doc's records. There are nmuerous references about my hands/arms being cyanotic or ischemic. with the associated reddish/bluish colour and decreased temperature, related to the RSD/CRPS. These findings are particularly documented before and AFTER the stellate nerve blocks. (after the blocks, the skin colour/temp changes improve dramatically, amd the pain is significantly reduced). Although I have not had a thermogram, my pain doc places special temperature pads on both of my hands, and records the temp before and AFTER the blocks. (warmer AFTER the block).

I am not sure why thermograms are not used more regularly here in the U.S. to help diagnose RSD/CRPS. There are many scientific articles that recommend the use of a thermogram to aid in the diagnosis of RSD, the International Reflex Symathetic Dystrophy Foundation, etc.

Another interesting thing I saw was the "rationale" for a trial Spinal Chord Stimulator--and that the literature shows that Spinal Chord Stimulation can help improve "microvascular circulation".

Although I am not as well-versed technically in chemistry, etc. as many of the other posters here, this ischemia/cyanotic aspect got me thinking...

When someone has a partially clogged artery to the heart, and the heart muscle is not getting enough blood flow to the heart muscle, the patient experiences "angina"---PAIN as a result of the heart being deprived of blood and OXYGEN in order to keep the muscle healthy and functioning properly.
If the supply of blood is "cut off" for a significant period of time, the heart muscle experienced permanent damage---otherwise known as a "heart attack". That portion of the damaged heart muscle no longer functions; it looses the ability to contract, due to scar tissue, and also the nerves cannot conduct electrical impulses properly across the area of scar tissue.

So, it kind of makes sense, as Frogga pointed out, that with RSD, and ichemic reperfusion injury as Vicc has pointed out, that the muscles, nerves and bones in an RSD patient will similarly be negatively affected. Skin, nerves, muscles and bones are all "organs" of the body which MUST have adequate blood supply and oxygen in order to maintain healthy intergrity.

As to WHY some doctors do not just come right out and label these colour changes and decreased temperature of the skin as a result of ischemia or cyanosis is baffling--these are "symptoms" of ischemia/cyanosis, and part of the diagnostic criteria for RSD/CRPS, if I understand this correctly.

Of course, as to WHY this phenomena occurs in RSD is the "mystery"!! But, it sure is an interesting topic!

Sincerely,

Brokenwings