In the endless list of known rare diseases, there are some as mysterious to the scientific community as Sudeck syndrome, the first recording dates from 1864.
Throughout this article we will describe what this strange syndrome is that causes immense pain to those who seem to do so. We will also talk about its symptoms, possible causes and treatment.
What is Sudeck Syndrome?
Sudeck’s disease, also known as complex general pain syndrome (CRPS), it is a disease characterized by being quite painful affecting one or more members of the body.
This condition tends to appear after some type of injury or operation, and is distinguished by a syndrome, multisymptomatic and multisystem. The degree of pain and the course of Sudeck syndrome does not have to match the extent of the injury that triggers it.
It is essential that this rare syndrome be diagnosed as early as possible. If not, it could end up spreading to all members, Make your recovery much more painful and difficult.
Considering the high levels of pain caused by this disease, the person can reach manifest severe psychological disorders, drug addiction or even develop a complete handicap.
Another factor that makes this disease so debilitating for the person who suffers from it is that its course is completely unpredictable and can vary greatly from person to person.
Symptomatology and clinical picture
As mentioned above, Sudeck’s disease has a wide variety of clinical features. This symptomatology includes pain or skin and bone changes. Here is a description of each of these clinical symptoms:
This syndrome has the uniqueness that the person experiences a disease disproportionate to the extent of the injury or the damage that causes them.
In addition, it may be accompanied by mobility difficulties that appear after the injury. One of the first symptoms to appear in patients with Sudeck syndrome is severe, constant, deep, and burning pain.
Finally, any type of friction, regardless of the intensity, is experienced as a painful sensation of the highest level.
2. Skin disorders
The dermis may show symptoms of dystrophy or atrophy, as well as dryness with or without flaking. In addition, the abnormal sympathetic activity that causes this disease may be related to changes in skin pigmentation, skin temperature and sweat rates.
3. Bone disorders
Sudeck syndrome can lead to bone wear or osteoporosis of the joints. This wear is visible on x-rays and bone scans.
4. Motor disorders
People affected by this disease live great difficulty in performing any type of movement. These difficulties are caused by the intense pain they experience due to the increased muscle tone.
As a result, patients tend to slow their movements thus generating diffuse muscle atrophy. Other motor symptoms are tremors or involuntary reflex movements.
In most cases, patients have localized inflammation at the site where the pain is generated.
All of these symptoms tend to be at the site of the injury. However, as the disease progresses, all of these symptoms will start to spread. There are 3 models that describe the spread of the disease:
- Continuous type model: symptoms spread upwards. For example, from the wrist to the shoulder.
- Mirror image type pattern: propagation at the opposite end.
- Model of independent type: in this case, the symptoms spread to an area away from the body.
Causes and risk factors
The causes of Sudeck’s disease are currently unknown. So much again we do not understand why the sympathetic system constantly remains in hyperactive mode.
Some theories hypothesize that this hyperactivity causes an inflammatory response that causes constant spasms at the site of the injury. Likewise, these spasms can increase the pain more and more, thus becoming a continuous circle of discomfort.
Although the causes are unknown, it has a number of risk factors associated with Sudeck syndrome. These are:
- previous surgeries
- Spine conditions.
- Idiopathic disorders.
- neurological damage both central and peripheral.
- Cardiovascular illnesses.
- previous injuries, Repetitive trauma or repetitive movement disorders.
Since there is no specific diagnostic evidence for Sudeck syndrome, a differential diagnosis must be made in which any other disorder of similar symptomatology is excluded.
As a result, the diagnosis will be made primarily by observing the signs and symptoms. Some of the tests that can be done to try to diagnose this condition are:
Using x-rays, it can be identified a class of spotted osteoporosis characteristic of this syndrome.
2. Nuclear magnetic resonance
This is a useful test for the early detection of Sudeck syndrome, especially when the lesion is located at hip height.
Thermography is a test in which the use of a specialized camera is it can measure the heat emitted by the body.
4. Laboratory analysis
Blood and urine tests will check for the presence of hypertriglyceridemia, hyperuricaemia, hypercalciuria and hydroxyprolinuria.
The most important goal of treatment for Sudeck syndrome is get the patient to use the affected limb.
Through the use of drugs, physiotherapy or nerve blockers, the goal is to reduce pain. Likewise, intervention with physiotherapy he will teach the patient to use his affected limb in his daily activities.
Physical exercise, such as swimming or any other aquatic activity, has been shown to be very effective in patients with lower extremities.
Psychological support is essential in the treatment of Sudeck syndrome. Its objective is strengthen the mental or psychological aspects of the diseaseIn addition to motivating the patient to apply pain management techniques.
If this treatment is successful in the early stages of the disease, the probability of complete remission is about 85%. In cases where the disease does not receive proper treatment, it can become chronic.