Orthopaedy

Complex regional pain syndrome

Complex regional pain syndrome is characterized by changes in certain tissues of the body. Most often the joint of the lower or upper limbs is affected, the disease covers the skin, soft tissue and bone. At first the disease was described in 1900 by German surgeon Paul Martin Sudeck (1866-1938).

Symptoms

The first stage:

  • redness, swelling;
  • skin is hot to the touch; pain;
  • limited mobility.

Second stage:

  • skin has a bluish tint;
  • edema;
  • muscle spasm;
  • severely limited mobility.

The third stage:

  • skin and muscle atrophy;
  • the joint loses its mobility.

Causes

Complex regional pain syndrome may develop as a result of the defeat of the previously injured tissue or excessive burden on the injured bone. The compression of the tissue at the wrong bandaging or scars that violate blood circulation can be cause of the disease. It is expected that the development of dystrophy occurs under the influence of psycho-emotional factor – the disease often affects mainly very sensitive, suffering from various phobias people.

Treatment

Treatment depends on the stage of the disease. The acute stage of the disease is characterized by intense muscle condition. The affected limb is immobilized with a special bus. Reflexology and medication helps to normalize the tone of the autonomic nervous system. Thermotherapy or cryotherapy, as well as therapeutic exercises are used for chronic course of the disease to stimulate circulation and restore mobility.

In the acute stage, it is necessary to spare the sick limb.

The first symptom of complex regional pain syndrome is the inflammation: the skin becomes red, swollen, itchy, and after a while becomes bluish. Movement of the affected limb is very painful. Inflammation does not necessarily becomes into complex regional pain syndrome, but after its occurrence you should to see a doctor. Sometimes the inflammation disappears spontaneously, but it is prone to relapse, which contribute to the development of dystrophy.

The doctor will do an x-ray of the affected part of the body and immobilizes the patient limb. He will appoint a pain medication, corticosteroids, calcium supplements. Sometimes the pain is reduced surgically or by injection of medicines in the sympathetic nerves.

Course of the disease

Doctor Sudeck described three stages of the disease:

  • Stage 1 – acute. Symptoms of inflammation are severe pain in the affected joint, limited mobility.
  • Stage 2 – dystrophic. The redness disappears, but the swelling persists. The skin in the affected area becomes cold, hard, it becomes bluish. Muscle tone is increased. Skin and muscle gradually atrophy. Characteristic spots are seen near the bone on the X-ray.
  • Stage 3 – atrophic. The disease becomes chronic. There is a loss of bone tissue, skin and muscles atrophy, progressive restriction of mobility in the joint to its full rigidity; ankylosis is possible. The pain increases, the skin and subcutaneous adipose tissue thinning, sweating increases.

People suffering from Sudeck atrophy experience extreme pain, despite the fact that the pronounced physical changes may not be available.

Is this syndrome dangerous?

Often, the first and second stages of the disease can still be cured. In the third stage atrophy occur which irreversibly affects tissue and joint. Physiotherapy can partially restore the mobility of the affected joint.

Prevention

Reliable means of prevention are absent. You must constantly be careful. After trauma necessarily listen to the “warning signs” that your body “sends” to you.