The clinical picture of Sudeck’s disease, also known as CRPS: Complex Regional Pain Syndrome, describes a symptomatology that not only sounds complex for borrowers, but where the treatment must also be considered complex. The therapy depends on the symptoms of the respective stages, which are described first in the following:
Treatment/physiotherapy in the stages
In physiotherapy for Sudeck’s disease, it makes sense to adapt the treatment measures of physiotherapy and physical therapy to the stage of the disease, since different symptoms are in the foreground at different stages.
- Stage 1: In the first stage, i.e. in the inflammatory stage, the affected limb should be carefully moved through, paying particular attention to a final movement of the joints to prevent later contractures or stiffening of the joints. Active movements should also be integrated into the exercise program to actively train the muscles.
During the resting phases, the arm or leg should be elevated and a cooling compress can be applied for a short time to support the muscles. The use of ice packs is not recommended because of the limited blood supply in Sudeck’s disease. In addition, manual lymphatic drainage and electrotherapy with a TENS device can be used if the patient feels comfortable with it.
- Stage 2: In the second, dystrophic stage, the extremity should be moved actively rather than passively to avoid pain stimuli.
Very cautious manual mobilization may be indicated at the beginning of stiffening. In addition to physiotherapy, baths such as the 2-cell bath can have a soothing effect in physical therapy. Manual lymph drainage or a foot reflexology massage can also alleviate the symptoms, as in the first stage.
- Stage 3: The third stage, the atrophic stage, is the restoration of the function of the extremity. The physiotherapeutic measures and the treatment options of physical therapy are applied as in the previous stages. In addition, exercises to improve gross and fine motor skills, muscle and strength-building exercises against resistance and mobilizing exercises can be performed.
