Sudeck’s Disease Definition
Sudeck’s disease (Sudeck dystrophy) is an inflammatory disease of connective tissue. Sudeck’s disease usually occurs after an injury in the arm, hand, shoulder, foot or leg.
Sudeck’s disease is characterized by the recurrence of pain, swelling, mobility disorders, skin changes, differences in temperature at the location of the wound after healing. In severe cases, there was a total loss of function of the extremities involved.
The treatment of Sudeck’s disease requires patience and activities on the part of the subject. Most treatment occurs early, the chances of a cure. Menopausal women are most commonly affected by Sudeck’s disease.
The disease became known as the Hamburg surgeon Paul Sudeck in 1900, it has nevertheless been described before in soldiers with gunshot wounds.
Sudeck’s Disease Causes
- Extremity injury after an accident (eg. Fractures, contusions, sprains, burns), wound after surgery, local infection (abscess)
- Enhanced physiotherapy after a quiescence after injury
- Neurological disease
- Spontaneous occurrence of Sudeck’s disease, without apparent cause (rare)
The occurrence of Sudeck’s disease does not depend on the severity of the injury, even very slight injury may be followed by a Sudeck’s disease. For this reason, it is estimated that excess reflex mechanism of the nervous system is the origin of the disease.
Psychological factors present before the accident (death of a loved one, marital problems, or other professional, depression, anxiety) appear to favor the occurrence of the disease. At present, it remains unclear why a subject develops a Sudeck’s disease and another does not develop, then they had the same injury.
Sudeck’s Disease (Foot and Hand)
There are three stages in the disease:
- Stage I: inflammation accompanied by swelling, redness and hyperthermia
- Stage II: circulatory disorders accompanied by hypothermia
- Stage III: atrophy
Sudeck’s Disease Symptoms
- Pain: pain at rest, nocturnal movement
- Skin changes: swelling of the skin (it becomes tight, shiny, pasty), red-blue color, increased sweating, superficial veins are very visible.
- Temperature difference: first hyperthermia (compared to a healthy part of the body), then cooling the affected area.
- Swelling: the joints are swollen and the disabled.
At an advanced stage:
- Muscular atrophy: after inflating, the muscles become very thin.
- Atrophy of the skin: the skin appears smooth, glossy and it is difficult to pinch, a hair growth occurs mainly at the back of the hand and foot on top of
- Stiffness: the capsules and ligaments atrophy and joints stiffen
- Temperature shift: due to lack of circulation, local hypothermia occurs
- Osteoporosis is only visible on x-ray
Sudeck’s Disease Diagnosis
There is no biological test to highlight Sudeck’s disease. The physician makes the diagnosis based primarily on physical findings and history.
- Temperature measurements: temperature measurement generated by the body surface
- Measuring the secretion of sweat
- Radiography, CT, MRI: to highlight a bone decalcification.
- Blockages friendly: using anesthesia, they can reduce sympathetic activity *, this method allows to obtain diagnostic information and a therapeutic action, insofar as Sudeck’s disease depends on the sympathetic system. * the sympathetic part of autonomic nervous system.
- Scintigraphy in three phases: review specific nuclear medicine
The pain and swelling in the limbs may also come from other illnesses, so it is important to eliminate (venous thrombosis, lymphedema as accumulation of fluid and lymphatic system disorders, lymph node involvement in cases of breast cancer).
Sudeck’s Disease Treatment Options
Early treatment, often in the hospital, led by an experienced physician (rheumatologist, anesthesiologist, neurologist, orthopedist and sometimes) is crucial in terms of chances of recovery. Treatment should consider both physical and psychological factors.
The goal of treatment is the preservation of the normal functionality of the affected body part, that is to say, the mobility of the extremities. Treatment requires patience from the patient and physician. It is very difficult to influence the course of the disease and the psychological burden caused by the pain is very important.
Sudeck’s Disease Drug treatment of pain
Do not try to heat treatment on its own initiative: the heat usually increases the symptoms. In the treatment of pain, the type of pain is considered.
The following substances are used:
- Antirheumatic drugs: If prolonged pain with inflammation
- Antidepressants: If prolonged pain and sleep disorders
- Opioids, opiates: if very intense pain, pain triggered by the sympathetic nervous system, muscle cramps
Other possibilities to fight against pain
- Blockages friendly: using anesthesia, they can reduce sympathetic activity *, this method allows to obtain diagnostic information and a therapeutic action, insofar as Sudeck’s disease depends on the sympathetic system. * The sympathetic part of autonomic nervous system.
- Electrical stimulation of the spinal cord
- Epidural anesthesia: blocks nerve conduction in the spinal cord
Sudeck’s Disease Other drugs
- Drugs inhibiting bone destruction (calcitonin, bisphosphonates)
It is important that the patient actively participates and takes its responsibilities during treatment.
- First of all, to rest; possibly splinting
- Elevation of the affected
- Cool slightly (NOT ice), carbon dioxide baths costs
- Manual lymphatic drainage
- Electrotherapy, TENS (transcutaneous electrical nerve stimulation: inhibition of conduction of pain due to nerve stimulation by electrical current)
- Massages, connective tissue
- Carefully active physiotherapy
- Occupational therapy to maintain mobility
- Specific training with specialists
- Learning relaxation techniques, psychosocial
Sudeck’s Disease Psychotherapy
- Psychological and psychosocial issues and if necessary, their close circle
Sudeck’s Disease Complementary Medicine
The following methods of complementary medicine have been proven effective in Sudeck’s disease: the Feldenkrais Method (specific form of movement therapy), neural therapy, homeopathy, acupuncture. These techniques can be used to complement conventional medicine.
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