Trix, I'm so sorry to continue the diversion of subject in your thread, but I feel that if a poster submits misleading and frightening information, it should be addressed.

I've split my post in two.

Tayla - I think it's fairly obvious, surely, that dystonia as it relates to RSD is being discussed here, not dystonia in general. Some of us are pretty bright and well informed actually, even if we're not nurses...

Mommyjen -
All good information is good. All incorrect information is dangerous, specially on a medical support forum. I can't see the balance in you coming out with sweeping generalisations, red-herrings and out-of-date information and then, when you are gently supplied with grounded information that challenges your claims, you shrug and go "Hey...whatever....".

You will be challenged, however, on a forum where everyone's experience of RSD is different. Many of us try to keep abreast of new research and can spot a dodgy fact straight away. But I wish you'd start to broaden your education about RSD, this is getting tedious...

About Roz's references:
These days it is not so much a paper journal that counts, but the quality of the publication. All three of Roz's refs are from highly respected publications. I mention this because you don't seem to have grasped that fact.

Roz's first cited reference
http://www.rsdfoundation.org/en/en_c...uidelines.html
is a web publication of the the "bible" of protocol for the medical profession, written by Anthony F. Kirkpatrick, M.D., Ph.D., Chair, Scientific Advisory Committee, Director of Research.

You say:
That is not what Dr. Kirkpatrick says:

"# Movement Disorder - Patients with RSD / CRPS have difficulty moving because they hurt when they move. In addition, there seems to be a direct inhibitory effect of RSD / CRPS on muscle contraction. Patients describe difficulty in initiating movement, as though they have "stiff" joints. This phenomena of stiffness is most noticeable to some patients after a sympathetic nerve block when the stiffness may disappear. Decreased mobilization of extremities can lead to wasting of muscles (disuse atrophy). Some patients have little pain due to RSD / CRPS but instead they have a great deal of stiffness and difficulty initiating movement.7 Tremors and involuntary severe jerking of extremities may be present. Psychological stress may exacerbate these symptoms. Sudden onset of muscle cramps (spasms) can be severe and completely incapacitating. Some patients describe a slow "drawing up of muscles" in the extremity due to increased muscle tone leaving the hand-fingers or foot-toes in a fixed position. This muscle disorder is called dystonia and it can be extremely disabling.

Patients with such seemly bizarre movements might be inaccurately diagnosed with a psychogenic movement disorder. Additionally, the fact that quite extreme behavioral changes often follow rather trivial injuries in patients with RSD / CRPS, this observation might contribute to the perception that the patient suffers from a psychogenic disorder as well.

Specific diagnostic criteria have been established for the diagnosis of psychogenic movement disorders in cases involving RSD / CRPS. 10 Unfortunately, physicians sometimes fail to follow these diagnostic guidelines and carelessly report a "psychogenic" disorder. 11 This misdiagnosis can be devastating to the patient and can lead to delaying urgent medical care.

A clinical test sometimes used to demonstrate that a patient is faking muscle weakness is called "give away weakness". This test is NOT a reliable indicator of a psychogenic movement disorder. Patients with RSD / CRPS will give away when a force is applied to their extremity because of pain. Also, because patients with RSD / CRPS have difficulty sustaining muscle contraction, they will give away as well."

Her second reference is from emedicine:
http://www.emedicine.com/emerg/topic497.htm
which is not a journal but is the original open access comprehensive medical textbook for all clinical fields. The author is Dr. Steven J Parrillo, DO, FACOEP, FACEP, Assistant Professor, Department of Emergency Medicine, Jefferson Medical College; Medical Director of Emergency Medicine, Einstein Elkins Park and Germantown Community Health Services; Chair, Emergency Management Committee, Albert Einstein Medical Center.

The third reference *is* a medical journal publication:
http://www.neurology.org/cgi/content...act/56/12/1762
Clinical aspects of multifocal or generalized tonic dystonia in reflex sympathetic dystrophy
J.J. van Hilten, MD, PhD;, W.J.T. van de Beek, MSc;, A.A. Vein, MD, PhD;, J.G. van Dijk, MD, PhD; and H.A.M. Middelkoop, PhD
From the Department of Neurology, Leiden University Medical Center, the Netherlands.

Since you brought up the subject of dystonia and muscle disuse , you might also be interested in this extract, also from the Guidelines:

"Failure to mobilize the affected region of the body might be a critical factor in prolonging the recovery from RSD / CRPS. However, disuse of muscle does not appear to be responsible for the genesis of RSD / CRPS. For example, investigators in Sweden have reported highly unusual data that makes it difficult to explain the genesis of RSD / CRPS simply on the basis of disuse. They carried out a pathological analysis of peripheral nerve and muscle taken from amputated legs of eight patients with RSD / CRPS. 13 In all patients, amputation was performed because the painful (hyperpathic) limb was useless or subject to recurrent infections. Skeletal muscle specimens were abnormal in all cases, but myelinated nerve fibers were normal, and in half the patients there was a loss of unmyelinated fibers. These findings suggest a microangiopathy in the affected limbs. Thus, patients with RSD / CRPS have tissues that are truly abnormal, and abnormal in ways that cannot be readily explained by disuse and/or psychological factors.