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Understanding and Treating Reflex Sympathetic Dystrophy (RSD) with Acupuncture


Reflex Sympathetic Dystrophy (RSD), often triggered by trauma, is also known as Posttraumatic Pain Syndrome or Posttraumatic Sympathetic Dystrophy. It is characterized by intense burning pain, hypersensitivity to touch, excessive sweating, and pathological changes in bones, skin, and muscles in the affected area or the region innervated by the same nerve. Also referred to as Complex Regional Pain Syndrome (CRPS), it primarily affects the limbs and can result from various types of trauma, including injuries, sprains, fractures, surgical procedures, and vascular or nerve damage, as well as brain injuries. Conditions like Posthemiplegic Shoulder Pain, Shoulder-Hand Syndrome, or Shoulder-Arm Syndrome, often seen post-stroke, are examples. RSD is frequently misdiagnosed due to a lack of clinical awareness, leading to delayed treatment and potentially irreversible changes in the affected limb's bones and muscles. About 50% of RSD patients experience prolonged pain, lasting up to six months or even years. Acupuncture, particularly in the early stages of RSD, has shown excellent therapeutic effects.


Due to the high sensitivity of the affected area in RSD patients, gentle stimulation is generally sufficient, with the intensity of needle sensation tailored to patient tolerance. Given the stubborn and challenging nature of RSD, treatment courses are typically extended, sometimes lasting several months, until symptoms are fully controlled. Infrared radiation is often used concurrently during needle retention.


Several clinical reports have attested to the effectiveness of acupuncture in treating RSD. In treatment, careful selection and stimulation of sensitive acupoints are crucial. Typically, acupoints on the Yang surface or Yang meridians are selected, but Yin surface or meridian points should not be overlooked. These Yin points can significantly influence local vasomotor function, and combined stimulation of Yin and Yang points can more comprehensively target the nerves innervating the entire affected limb.


The use of contralateral needling (Miu ci) is also significant in treating RSD. This method is not only suitable for cases where the affected side is too sensitive for stronger acupuncture stimulation, but it also addresses the sympathetic reflex symptoms that often involve the healthy side, especially in prolonged cases. Thus, contralateral needling serves both therapeutic and preventive roles in managing RSD.

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