Etiopathogenesis of reflex sympathetic dystrophy: a review and biopsychosocial hypothesis.

Reflex sympathetic dystrophy (RSD) is an enigmatic condition. Many clinicians, however, believe that psychological factors could contribute to the onset and persistence of the syndrome. In this article we critically review the evidence from psychometric and psychodynamic/biographical studies that suggests a role for such factors. An etiopathogenetic hypothesis based on the authors' clinical experience and the foregoing literature also encompasses elements of stress-coping theory, cognitive-behavioral views on chronic pain, and the psychobiological approach to sympathetic nervous system dysfunction. Implications of this model for future psychological research and the therapeutic treatment of RSD are discussed.

Evaluation of a brief chronic pain management program: effects and limitations.

The short- and long-term efficacy of a multidisciplinary pain management program was evaluated in a group of 35 chronic pain patients. At posttreatment, patients reported lower pain levels, more up-time, less medication consumption, an increase in positive cognitions about pain, and more (psychologically oriented) active coping. At follow-up, treatment gains were only partly maintained. A theoretical model regarding the impact of the treatment program was discussed. Plans for future efforts to enhance transfer and maintenance of therapeutic benefits were presented.