Sudeck’s syndrome: symptoms, causes and treatment

This disease is characterized by being very painful and affecting one or several extremities.

Within the infinite list of known rare diseases, there are some as mysterious to the scientific community as Sudeck's syndrome, the first record of which dates back to 1864..

Throughout this article we will describe what this strange syndrome consists of, which causes immense pain in those who seem to suffer from it. Also, we will speak of its symptoms, its possible causes and its treatment.

What is Sudeck's syndrome?

Sudeck's disease, also known as complex general pain syndrome (CRPS), is a disease characterized by being quite painful, affecting one or more limbs that affects one or more body extremities.

This condition tends to originate after some type of injury or operation, and is distinguished by being a multisymptomatic and multisystemic syndrome. The degree of pain and the evolution of Sudeck's syndrome does not necessarily correspond to the magnitude of the injury that triggers it.

It is vital that this rare syndrome be diagnosed at the earliest possible stage. Otherwise, it could it could end up spreading to all limbsmaking recovery much more painful and difficult.

Given the high levels of pain caused by this disease, the person can manifest serious psychological disturbances. manifest serious psychological disturbances, pharmacological dependence, or even develop complete or even develop complete disability.

Another factor that makes this disease so disabling for the sufferer is that its course is totally unpredictable and can vary greatly from one person to another.

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. The following is a description of each of these clinical symptoms:

1. Pain

This syndrome is unique in that the person experiences pain of disproportionate proportions. of disproportionate proportions in comparison with the magnitude of the injury or damage that causes them. 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's syndrome patients is severe, constant, deep and burning pain.

Finally, any kind of friction, no matter how intense, is experienced as a painful sensation of the highest level.

2. Cutaneous alterations

The dermis may show symptoms of dystrophy or atrophy, as well as dryness with or without desquamation. In addition, the abnormal sympathetic activity that causes this disease may be associated with alterations in skin pigmentation, skin temperature and sweating levels..

3. Bone alterations

Sudeck's syndrome can generate bony wasting or osteoporosis in the joints. This wear can be observed by means of X-rays and scans of the bones.

4. Motor disorders

People affected by this disease experience great difficulties to carry out any type of movement. These difficulties are caused by the intense pain they experience due to increased Muscle tone.

As a consequence, patients tend to reduce their movements, thus generating a diffuse muscular atrophy. Other motor symptoms are tremors or involuntary reflex movements.

5. Inflammation

In most cases patients present with localized inflammation at the site where the pain is generated.

All these symptoms tend to be localized at the site of the lesion. However, as the disease progresses, all this symptomatology will begin to spread. There are 3 patterns that describe the spread of the disease:

• Continuous type pattern: symptoms spread in an ascending manner.. For example, from the wrist to the shoulder.
• Mirror image type pattern: spread to the opposite limb. towards the opposite extremity.
• Independent type pattern: in this case the symptoms spread to a distant area of the body. to a distant area of the body.

Causes and risk factors

The causes of Sudeck's disease are as yet unknown. Therefore, it is not yet why the sympathetic system is constantly in hyperactive mode is not yet understood..

Some theories hypothesize that this hyperactivity leads to an inflammatory response that causes constant spasms at the site of injury. Furthermore, these spasms may cause the pain to increase more and more, thus becoming a continuous circle of discomfort.

Although the causes are not known, there are a number of risk factors that are known to cause a number of risk factors that are associated with Sudeck's syndrome.. These are:

• Previous surgeries.
• Infections.
• Spinal conditions.
• Idiopathic disorders.
• Neurological lesions both central and peripheral.
• Cardiovascular diseases.
• Previous traumasrepetitive trauma or repetitive motion disorders.

Diagnosis

Since there are no specific diagnostic tests for Sudeck's syndrome, it is necessary to make a differential diagnosis in which any other disorder with similar symptomatology is ruled out.

As a result, the diagnosis will be made primarily by observation of signs and symptoms. Some of the tests that can be performed to try to diagnose this disease are:

1. X-rays

Through the use of X-rays, it is possible to identify a kind of mottled osteoporosis characteristic of this syndrome. characteristic of this syndrome.

2. Magnetic resonance imaging

This is a useful test for early detection of Sudeck's syndrome, especially when the lesion is located at the hip.

3. Thermography

Thermography is a test in which, through the use of a specialized camera, the heat emitted by the body can be measured. can measure the heat emitted by the body..

4. Laboratory tests

Blood and urine tests will be used to evaluate for the presence of hypertriglyceridemia, hyperuricemia, hypercalciuria and hydroxyprolinuria..

Treatment

The most important objective in the treatment of Sudeck's syndrome is getting the patient to use the affected limb.

Through the use of medication, physical therapy or nerve blocks, the aim is to reduce the pain. Also, physical therapy intervention will teach the patient to use his or her affected limb in day-to-day activities.

Physical exercises such as swimming or any other aquatic activity have been shown to be very effective in patients affected by lower limb pain.

Psychological support is of vital importance in the treatment of Sudeck's syndrome. Its objective is to to reinforce the mental or psychological aspects of the diseaseas well as to motivate the patient to carry out pain management techniques.

If this treatment can be carried out during the early stages of the disease, the probability of complete remission is approximately 85%.. In cases where the disease is not adequately treated, it can become chronic.