Synonyms in a broader sense
- Sudeck`sche healing derailment
- Algodystrophy
- Causalgia
- Sudeck Syndrome
- Posttraumatic Dystrophy
- Complex Regional Pain Syndrome
- Complex regional pain syndrome I and II
- Sympathetic reflex dystrophy
- Sudeck ́sche Disease
Introduction
In Sudeck’s disease (also known as CRPS I= Cronic Regional Pain Syndrome) at least one joint is affected. This is usually on the hand or foot, but knee, hip or shoulder attacks are also conceivable in this disease. Initially, the symptoms are relatively unspecific and can easily be confused with those of inflammation. However, the inflammation values in the blood are not increased.
Definition
Painful dystrophy (nutritional disorder) and atrophy (shrinkage) of soft tissues (muscles, skin) and bones in the extremities with typical stage-like course. Sudeck’s disease can cause many different symptoms. A generalization does not do justice to the symptom complex. The frequency of individual symptoms (signs of disease) was investigated by Laan and Goris, 1997. Inflammatory symptoms: Atrophy (tissue loss): Neurological symptoms: Symphatic symptoms:
- Pain (burning deep pain) 92%
- Difference in skin temperature 98
- Movement restriction 90
- Stress related complaints 98%
- Skin 38%
- Nails 15% of
- Muscles 40
- Hypaesthesia (reduced feeling of the skin) 69
- Hyperpathy (painful touch sensitivity) 75%
- Coordination disorders 53%
- Tremor (trembling) 54
- Involuntary movements 19%.
- Muscle spasms (muscle cramps) 11%
- Pareses (paralysis) 98%
- Excessive sweating 57%.
Causes
The search for the cause of Sudeck’s disease is still ongoing. It is a very heterogeneous clinical picture with varying degrees of different symptoms. The following things are considered to be important for the development of the disease: The combination of increased sweat secretion and dilatation of the vessels is a typical function of central thermoregulation.
It normally affects the entire body and, under certain conditions, ensures that body temperature is maintained. The spontaneous unilateral occurrence of this reflex pattern in Sudeck’s disease is an expression of disturbed central thermoregulation. Under physiological conditions, there is no interaction between the sympathetic and pain-conducting systems.
Stimulation of the sympathetic boundary strand does not lead to activation of pain-conducting nerve cells. This situation changes under the pathophysiological conditions of neuropathic Sudeck’s disease pain. Studies suggest that localized nerve inflammation (neurogenic inflammation) is important in Sudeck’s pain, acute swelling (edema) and vasodilation.
The paralysis (paresis) of almost all muscles of the affected limb is neither caused by the pain nor by the edema, but in the absence of a peripheral nerve lesion it is most likely the result of a reduced activity of central motor neurons. This underlines the important role of the central nervous system (CNS). Psychological symptoms (depression, anxiety, tendency to somatization, inhibition of aggression and emotional instability) occur more frequently. However, the psychological symptoms are demonstrably the result and not the cause of the disease.
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