Reflex Neurovascular Dystrophy


Reflex neurovascular dystrophy (RND) is a painful condition that leads to severe pain in the joints and muscles in children. The pain may be described as sharp, burning, achy, crampy, a pounding hammer, or cutting like a knife. The pain is caused by a nerve sensitivity whereby the nerves in the body send pain signals to the brain inappropriately. RND affects girls more than boys (80 percent girls).

Symptoms and Diagnosis

RND can be associated with other symptoms including:

  • headaches
  • stomach pains
  • chest pain
  • painful menses
  • poor concentration
  • memory loss
  • insomnia
  • ringing in the ears
  • swelling
  • skin color changes
  • skin temperature changes
  • dizziness
  • loss of appetite
  • weight loss or weight gain
  • waking in the night
  • fatigue
  • extended napping
  • decreased performance in school

RND can also occur in children with growth plate fractures. The pain from RND typically is not helped by pain medications, and medical testing usually shows normal results.


At UPMC Children's Hospital of Pittsburgh, we have partnered with The Children’s Institute to create a treatment program for children with RND. The program consists of a combination of exercise therapy to retrain the affected nerves and pain reduction techniques such as biofeedback, stress reduction, and mindfulness. The program has treated children from western Pennsylvania as well as from around the country.

Learn more about common types of pediatric arthritis and other rheumatic diseases.

To schedule a consultation with a pediatric rheumatologist, call 412-692-5081.