Sudeck syndrome: symptoms, causes and treatment
Within the infinite list of known rare diseases, some are as mysterious to the scientific community as Sudeck's syndrome, whose first record dates from 1864 .
Throughout this article we will describe what this strange syndrome is that causes immense pain in those who see it. Also, we will talk about their symptoms, their possible causes and their treatment.
- Related article: "The differences between syndrome, disorder and disease"
What is Sudeck syndrome?
Sudeck's disease, also known as complex general pain syndrome (CRPS), it is a disease characterized by being quite painful which affects one or more body limbs.
This condition tends to originate after some type of injury or operation, and is distinguished by being a syndrome, multisymptomatic and multisystemic. The degree of pain and the evolution of the Sudeck syndrome does not have to correspond to the magnitude of the lesion that triggers it.
It is vital that this strange syndrome be diagnosed during the earliest possible stage. On the contrary, it could end up spreading to all the extremities , making your recovery much more painful and difficult.
Given the high levels of pain caused by this disease, the person can reach manifest serious psychological alterations, pharmacological dependence or, even, develop a complete disability.
Another factor that makes this disease so incapacitating for the person who suffers it is that its course is totally unpredictable and can vary in an exaggerated way between one person and another.
- Related article: "The 13 types of pain: classification and characteristics"
Symptomatology and clinical picture
As mentioned above, Sudeck's disease has a great variety of clinical characteristics. This symptomatology includes pain or Changes in the skin and bones. Next, we describe each of these clinical symptoms:
1. Pain
This syndrome has the singularity that the person experiences a pain of disproportionate proportions compared to the magnitude of the injury or damage that causes them.
In addition, it may be accompanied by mobility difficulties that appear after the injury. One of the first symptoms that appear in Sudeck syndrome patients is a severe, constant, deep and burning pain.
Finally, any kind of friction, whatever the intensity, is experienced as a painful sensation of the highest level.
2. Skin disorders
The dermis can present symptoms of dystrophy or atrophy, as well as dryness with or without desquamation. Also, the abnormal sympathetic activity that causes this disease can be related to alterations in the pigmentation of the skin, in the temperature of this and in the levels of sweating .
3. Bone alterations
Sudeck syndrome can cause bone wasting or osteoporosis in the joints. This wear can be observed through radiographs and bone scans.
4. Motor disorders
People affected by this disease experience great difficulties to make any kind of movement . These difficulties are caused by the intense pain they experience due to increased muscle tone.
As a consequence, patients tend to decrease their movements, generating diffuse muscular atrophy. Other motor symptoms are tremors or involuntary reflex movements.
5. Inflammation
In most cases, patients present localized inflammation at the site where the pain is generated.
All these symptoms tend to be located at the site of the injury. However, to the extent that the disease evolves, all this symptomatology will begin to spread. There are 3 patterns that describe the spread of the disease:
- Pattern of continuous type: the symptoms extend in an ascending way . For example, from the wrist to the shoulder.
- Pattern of mirror image type: propagation towards the opposite extremity .
- Independent type pattern: in this case the symptoms extend towards a distant area of the body .
Causes and risk factors
The causes of Sudeck's disease are now unknown. Therefore, still it is not understood why the sympathetic system is kept in hyperactive mode constantly .
Some theories hypothesize that this hyperactivity causes an inflammatory response that causes constant spasms at the site of the injury. Also, these spasms may cause the pain to increase more and more, thus becoming a continuous circle of discomfort.
Although the causes are unknown, there are a series of risk factors that are associated with Sudeck syndrome . These are:
- Previous surgeries
- Infections
- Conditions of the spine .
- Idiopathic disorders.
- Neurological injuries both central and peripheral.
- Cardiovascular diseases.
- Previous injuries , repetitive traumatisms or repetitive movement disorders.
Diagnosis
Since there are no specific diagnostic tests for Sudeck's syndrome, it is necessary to perform a differential diagnosis in which any other similar symptom disorder is ruled out.
Following this, the diagnosis will be made mainly by observing signs and symptoms. Some of the tests that can be carried out to try to diagnose this disease are:
1. Radiographs
By using x-rays you can identify a class of speckled osteoporosis characteristic of this syndrome.
2. Nuclear magnetic resonance
This is a useful test for the early detection of Sudeck's syndrome, especially when the lesion is located at the level of the hip.
3. Thermography
Thermography is a test in which by using a specialized camera it is can measure the heat emitted by the body .
4. Laboratory analysis
Blood and urine tests will assess the presence of hypertriglyceridemia, hyperuricemia, hypercalciuria and hydroxyprolino .
Treatment
The most important goal in the treatment of Sudeck's syndrome is get the patient to use the affected limb .
Through the use of medications, physical therapy or nerve blocks, it is intended to reduce the pain. Likewise, the intervention with physiotherapy will teach the patient how to use his affected limb in his day-to-day activities.
Physical exercises such as swimming or any other aquatic activity have been shown to be highly effective in affected patients of the lower extremities.
Psychological support is of vital importance in the treatment of Sudeck's syndrome. Your goal is reinforce the mental or psychological aspects of the disease , as well as motivating the patient to carry out pain management techniques.
If this treatment is carried out during the early stages of the disease, the probability of complete remission is approximately 85% . In cases in which the disease does not receive the appropriate treatment, this can lead to become chronic.
