Symptoms/3 stages of sympathetic reflex dystrophy | Physiotherapy/physical gymnastics Sudeck’s disease

Symptoms/3 stages of sympathetic reflex dystrophy

Sudeck’s disease is usually divided into 3 stages, but the clinical course of the disease is often not clearly defined.

  1. Stage: acute inflammation In the first stage, the inflammatory stage, the symptoms of acute inflammation predominate. These may include burning pain and overheating of the skin.

    There may also be doughy swelling, i.e. edema, limited function of the body part or joint, and a bluish or reddish coloration of the skin. In addition, the temperature regulation of the body part may be impaired, i.e. it may feel overheated or temporarily cool.

  2. Stage: dystrophic stage In this stage, the pain is often regressive, the skin is poorly supplied with blood, in contrast to the inflammatory stage, and therefore white and cold. The muscles of the affected region break down and bone decalcification can begin.

    A beginning stiffening of the joints is also possible.

  3. Phase: atrophic stage The dystrophic stage is followed by the atrophic stage, which is the last stage of this classification. In this phase, the pain is usually completely gone, but the affected body part is usually almost unusable. The further stiffening of the joints and the atrophy, i.e. the breakdown of the muscles, contribute significantly to this.

    The muscles and soft tissues have continued to deteriorate significantly at this stage and muscle contractures occur, further restricting the function of the affected body part. The decalcification of the bone continues to progress and the skin appears very thin and shiny.

>In order to be able to help the patient suffering from Sudeck’s disease, the physiotherapist in physiotherapy/physiotherapy uses techniques to restore the balance between the sympathetic and parasympathetic nervous systems. Connective tissue massage has proven its worth in this context.

Extensions of the vegetative nerves are located in the connective and supporting tissue, i.e. the skin, subcutis and fascia. This means that there are certain skin and connective tissue zones that can indicate certain organ dysfunctions. The physiotherapist can recognize these zones by visual and tactile findings.

One can imagine that in an affected connective tissue zone, the subcutaneous tissue sticks to the muscle fascia because the metabolic function is restricted there.It is possible that the patient has sensory disturbances at these sites, such as increased sensitivity to pain, changes in temperature, changes in elasticity and a deterioration in tissue perfusion of the area. These symptoms can all occur together in Sudeck’s disease, but they do not necessarily all have to occur. It is possible that the patient does not feel anything noticeable in the affected area and can still feel better after treatment by the physiotherapist.

Since the clinical examination of these effects one speaks of the neurovegetative holistic treatment according to Dr. Teirich-Leube. In this treatment, the treatment of the connective tissue influences the vegetative nervous system, the activity of the sympathetic nervous system is reduced and can thus work together with the parasympathetic nervous system again. In addition to the effects on the nervous system, blood circulation is improved locally, tension is lowered and adhesions in Sudeck’s disease are loosened.

Apart from influencing the autonomic nervous system by massaging the connective tissue, it is also appropriate to release tensions that are caused by relieving the patient’s posture in Sudeck’s disease. As the patient tries to relieve the strain on the affected hand or foot and uses it less for everyday activities, the opposite side is often overstrained and back problems can occur due to incorrect posture. In order to prevent this, physiotherapy for posture school is indispensable for Sudeck’s disease.

In addition to posture training, the mobility of the adjacent joints should also be maintained to prevent further loss of function. For this purpose, the physiotherapist can perform exercises with the patient and, together with the patient, draw up a self-exercise program which should be carried out regularly at home. In addition to the pure maintenance of movement of the adjacent joints, it is advisable to take part in physical activities, because moderate endurance sports can in turn have an influence on the autonomic nervous system and, in addition to the connective tissue massage, contribute to the balance of the sympathetic and parasympathetic nervous systems.