Reflex neurovascular dystrophy

Reflex neurovascular dystrophy (RND) is a painful neurovascular disease that constricts the blood veins and reduces the supply of oxygen to the skin, muscles and bones. This lack of oxygen can cause acid to build up, causing new pain that is then sent back through the cycle to cause the neurovascular nerves to constrict the blood flow again. The pain caused by RND can become so severe that interferes with the patient's ability to walk. RND usually only effects an area or two of the body, but can in rare cases affect the entire body. RND is more common among girls than boys (80% of children with RND are girls). A rare symptom of RND is nausea, causing the child to vomit on a daily basis.

RND can be caused by musculoskeletal inflammatory diseases such as arthritis but it can also be caused by psychological factors such as stress. Stress may continue to play a major role in RND even after the child has RND under control. It can relapse if the child feels depression, a lack of acceptance by society, or is injured.

The best known treatment of RND is extreme physical therapy. the only hospitals that have programs for RND are children’s hospital in Seattle, The Childrens Institute of Pittsburgh (an independent, non-profit organization providing individualized pediatric services), children's hospital of Philadelphia and another hospital in Florida and also in Texas. In a typical course of therapy, the child is put through 5 hours of therapy including physical, occupational and pool therapy. While sometimes painful, such therapy helps to improve blood flow and break the RND cycle. The therapy usually lasts between 2-4 weeks before the child has the RND under control. Small relapses and flare ups may occur, usually only during 5 years of the treatment, which is the average time until the child is pain free, thought RND can continue to occur and may never cease.