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Because currently there is no cure for reflex sympathetic dystrophy (RSD), the disorder may persist for a prolonged period of time and can have a significant psychosocial impact on patients. The chronic, severe nature of pain experienced by many RSD patients, particularly those with established and long-standing RSD, may lead to psychological comorbidity including depression, anxiety, feelings of isolation, and a sense of hopelessness and helplessness, and, in some cases, may increase the risk of suicide or suicide ideation. It is, therefore, important for patients and their families to recognize and understand the potential psychological effects of RSD and seek a thorough psychological consultation and evaluation as part of the overall strategy for managing RSD.

A variety of different treatment options are available to help RSD patients with concurrent psychological co-morbidity including drug therapy and cognitive behavior therapy. A multidisciplinary approach to treatment involving a pain management specialist, neurologist, physiatrist (specialist in physical medicine and rehabilitation), and/or a psychologist/psychiatrist may be necessary to help RSD patients learn to better cope and adjust to both the physical and psychological consequences of the disorder.

Because RSD is so poorly understood, there are physicians who are not familiar with the condition and its symptoms who perceive their patients' complaints to be psychiatric in nature ("it's all in your head"). Also, since RSD is related to many cases of workmen's compensation for injury occurring on the job, there may be a tendency for some health care providers to view the patient's complaint as malingering. This is a significant source of stress for many patients and may lead to significant delays in diagnosis and treatment. This situation adds to the psychosocial issues the patient already deals with due to chronic pain and interruption in their quality of life.

Some patients become depressed if their condition prevents them from doing things that are important to their independence and well being. Formerly independent people may have to rely on others for daily tasks, (e.g., dressing, cooking, and errands) which is not only inconvenient but they may also feel is also demeaning and robs them of self respect. It is important to address these feelings and to respond appropriately. It is hard for many patients to accept their changing condition and they actually go through a grieving process in the course of coming to grips with their new reality.

The medical literature describes four stages through which people move in relating to chronic pain:

• Hoping that there is some cure that will make the pain go away
• Wondering if the treatment they are receiving is appropriate
• Feeling anger, resentment, or depression when they realize the pain is not temporary
• Evaluating changes in lifestyle as they accept that permanent pain and varying levels of disability is their new reality.

Family and friends who form the support group around the patient must be educated and made aware of RSD, its treatment and rehabilitation, behaviors of the patient that should be encouraged or discouraged, and the supporting role they can play. It is very important for friends and family to understand what the patient is going through and allow the patient the opportunity to express their grief and frustration without being judgmental. Family and friends also need to be supportive and encourage the patient to keep their spirits up and to continue functioning to the best of their ability.