General information
Sudeck’s disease is a complex regional pain syndrome, which classically runs in three stages. In the final stage, atrophy (regression) of bones and soft tissues finally occurs; joints, skin, tendons and muscles shrink, resulting in loss of mobility. Sudeck’s disease always involves at least one joint, usually the hand or foot. The exact cause of this disease is still not conclusively clarified, but it is noticeable that it occurs more often after operations or injuries, in underlying diseases of the nerves, thyroid gland or heart, or when taking certain medications.
Symptoms
In the area of the lower extremity, Sudeck’s disease manifests itself most frequently on the foot; knees or hips are affected much less frequently. In addition to severe burning pain and hypersensitivity of the corresponding skin regions (which often cannot be localized exactly), one of the main symptoms of Sudeck’s disease is the change in the tissue. Affected areas are often unusually colored, swollen and/or overheated, and tend to overproduce sweat.
The stiffening of the joint can lead to uncontrollable trembling and/or lack of mobility and even paralysis. If Sudeck’s disease occurs on the foot, the biggest problem of those affected is that they often cannot walk properly. Pain is usually permanent, but increases when it occurs, shoes often no longer fit because of the swelling and the stiffening of the joint means that the foot can no longer roll properly when walking. Patients are therefore severely restricted in their everyday life.
Therapy
Therapeutic measures primarily pursue the goal of improving the mobility of the joint and ideally restoring it completely. This can be achieved by using medication, physical measures (physiotherapy, electrotherapy) and nerve blocks. These procedures serve to relieve pain, since local anesthesia reduces or eliminates the perception of pain by affected nerves.
For Sudeck’s disease of the foot, the ischiadicus nerve is usually blocked. Since this nerve (the strongest nerve of the entire body!) also leads to vegetative fibers (i.e. fibers that control various bodily processes, including blood flow), in addition to inhibiting pain, it also causes vasodilation and thus increased blood flow to the affected area, which has a positive effect on pain
