About sudeck's atrophy
What is sudeck's atrophy?
Reflex sympathetic dystrophy syndrome (RSDS), also known as complex regional pain syndrome, is a rare disorder of the sympathetic nervous system that is characterized by chronic, severe pain. The sympathetic nervous system is that part of the autonomic nervous system that regulates involuntary functions of the body such as increasing heart rate, constricting blood vessels, and increasing blood pressure. Excessive or abnormal responses of portions of the sympathetic nervous system are thought to be responsible for the pain associated with reflex sympathetic dystrophy syndrome.
The symptoms of reflex sympathetic dystrophy syndrome typically begin with burning pain, especially in an arm, finger(s), palm of the hand(s), and/or shoulder(s). In some individuals, RSDS may occur in one or both legs or it may be localized to one knee or hip. Frequently, RSDS may be misdiagnosed as a painful nerve injury. The skin over the affected area(s) may become swollen (edema) and inflamed. Affected skin may be extremely sensitive to touch and to hot or cold temperatures (cutaneous hypersensitivity). The affected limb(s) may perspire excessively and be warm to the touch (vasomotor instability). The exact cause of RSDS is not fully understood, although it may be associated with injury to the nerves, trauma, surgery, atherosclerotic cardiovascular disease, infection, or radiation therapy.
What are the symptoms for sudeck's atrophy?
Symptoms may change over time and vary from person to person. Pain, swelling, redness, noticeable changes in temperature and hypersensitivity (particularly to cold and touch) usually occur first.
Over time, the affected limb can become cold and pale. It may undergo skin and nail changes as well as Muscle spasms and tightening. Once these changes occur, the condition is often irreversible.
CRPS occasionally may spread from its source to elsewhere in the body, such as the opposite limb.
In some people, signs and symptoms of CRPS go away on their own. In others, signs and symptoms may persist for months to years. Treatment is likely to be most effective when started early in the course of the illness.
What are the causes for sudeck's atrophy?
The cause of CRPS isn't completely understood. It's thought to be caused by an injury to or difference in the peripheral and central nervous systems. CRPS typically occurs as a result of a trauma or an injury.
CRPS occurs in two types, with similar signs and symptoms, but different causes:
- Type 1. Also known as reflex sympathetic dystrophy (RSD), this type occurs after an illness or injury that didn't directly damage the nerves in the affected limb. About 90% of people with CRPS have type 1.
- Type 2. Once referred to as causalgia, this type has symptoms similar to those of type 1. But type 2 CRPS occurs after a distinct nerve injury.
Many cases of CRPS occur after a forceful trauma to an arm or a leg. This can include a crushing injury or a fracture.
Other major and minor traumas — such as surgery, heart attacks, infections and even sprained ankles — also can lead to CRPS.
It's not well understood why these injuries can trigger CRPS. Not everyone who has such an injury will go on to develop CRPS. It might be due to an interaction between your central and peripheral nervous systems that isn't typical and different inflammatory responses.
What are the treatments for sudeck's atrophy?
There's some evidence that early treatment might help improve symptoms of CRPS. Often, a combination of different treatments, tailored to your specific case, is necessary. Treatment options include:
Doctors use various medications to treat the symptoms of CRPS.
Pain relievers. Pain relievers available without a prescription — such as aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) — may ease mild pain and inflammation.
Your doctor may prescribe stronger pain relievers if OTC ones aren't helpful. Opioid medications might be an option. Taken in low doses, they might help control pain.
- Antidepressants and anticonvulsants. Sometimes antidepressants, such as amitriptyline, and anticonvulsants, such as gabapentin (Gralise, Neurontin), are used to treat pain that originates from a damaged nerve (neuropathic pain).
- Corticosteroids. Steroid medications, such as prednisone, may reduce inflammation and improve mobility in the affected limb.
- Bone-loss medications. Your provider may suggest medications to prevent or stall bone loss, such as alendronate (Binosto, Fosamax) and calcitonin (Miacalcin).
- Sympathetic nerve-blocking medication. Injection of an anesthetic to block pain fibers in the affected nerves may relieve pain in some people.
- Intravenous ketamine. Some studies show that low doses of intravenous ketamine, a strong anesthetic, may substantially alleviate pain.
- Medicines to lower blood pressure. Sometimes high blood pressure medications, including prazosin (Minipress), phenoxybenzamine (Dibenzyline) and clonidine can help to control pain.
- Heat therapy. Applying heat may offer relief of swelling and discomfort on skin that feels cool.
- Topical analgesics. Various topical treatments are available that may reduce hypersensitivity, such as capsaicin cream available without a prescription, or lidocaine cream or patches (Lidoderm, ZTlido, others).
- Physical or occupational therapy. Gentle, guided exercising of the affected limbs or modifying daily activities might help decrease pain and improve range of motion and strength. The earlier the disease is diagnosed, the more effective exercises might be.
- Mirror therapy. This type of therapy uses a mirror to help trick the brain. Sitting before a mirror or mirror box, you move the healthy limb so that the brain perceives it as the limb that is affected by CRPS. Research shows that this type of therapy might help improve function and reduce pain for those with CRPS.
- Transcutaneous electrical nerve stimulation (TENS). Chronic pain is sometimes eased by applying electrical impulses to nerve endings.
- Biofeedback. In some cases, learning biofeedback techniques may help. In biofeedback, you learn to become more aware of your body so that you can relax your body and relieve pain.
- Spinal cord stimulation. Your provider inserts tiny electrodes along your spinal cord. A small electrical current delivered to the spinal cord results in pain relief.
- Intrathecal drug pumps. In this therapy, medications that relieve pain are pumped into the spinal cord fluid.
- Acupuncture. The insertion of long, thin needles may help stimulate nerves, muscles and connective tissue to increase blood flow and relieve pain.
It's possible for CRPS to recur, sometimes due to a trigger such as exposure to cold or intense emotional stress. Recurrences may be treated with small doses of an antidepressant or other medication.
What are the risk factors for sudeck's atrophy?
Sudeck's atrophy is also called Complex regional pain syndrome (CRPS) which is a type of persistent pain that typically affects one's arm or leg. CRPS usually arises as a result of an injury, surgery, stroke, or heart attack. The pain is excessive in comparison to the intensity of the initial damage. The specific causes of CRPS are unknown. It is assumed to be caused by a difference or injury to the peripheral and central nervous systems. CRPS is usually caused by trauma or injury.
CRPS is infrequent, and its etiology is unknown. When treatment begins early, it is most successful. Progress and even remission are conceivable in such circumstances.
1. Women are three to four times more likely than men to suffer from CRPS.
2. CRPS can happen at any age, but it is uncommon in adolescents and children.
3. In the pediatric population, CRPS usually appears in early adolescence, with the lower end of the spectrum falling between the ages of 7 and 9 years.
4. The age of onset in adults ranges from 37 to 70 years of age. CRPS is most common among individuals of European ancestry (in about 66 to 80 percent of cases).
Pain that is constantly burning or throbbing, usually in the arm, leg, hand, or foot,Touch or cold sensitivity,Inflammation of the painful area,Skin temperature fluctuations,Skin color changes, ranging from white and blotchy to red or blue,Skin texture changes in the affected area, which could become tender, thin, or shiny,Hair and nail growth changes,Stiffness, swelling, and damage to the joints,Spasms, tremors, and weakness (atrophy),Reduced mobility of the affected body part
Pain,Swelling,Redness,Noticeable changes in temperature and hypersensitivity
Is there a cure/medications for sudeck's atrophy?
Whenever you experience prolonged pain that interferes with your life and isn’t relieved by over-the-counter medications, you should see your doctor.
CRPS II is a complex syndrome that may need a variety of specialists to treat it. These specialists may include experts in orthopedics, pain management, and even psychiatry, as chronic pain can take a toll on your mental health.
While CRPS II is a serious condition, there are effective treatments. The sooner it’s diagnosed and treated, the better your chances are for a positive outcome.