Synonyms
- 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
There is no generally recognized therapy concept. The therapy depends on the stage of the disease. The following stage-dependent therapeutic procedure is recommended.
Stage I Stage II Stage III
- Immobilization of the affected extremity in functional position
- Analgesics (painkillers)
- Physical therapy with lymph drainage and active movement exercises
- Electrotherapy
- Corticosteroids
- Nonsteroidal anti-inflammatory drugs (NSAIDs e.g. Diclofenac, Iboprofen®)
- Calcitonin (Karil®)
- In individual cases symphaticolysis due to border strand blockage
- Massages and passive movement exercises are contraindicated!
- Antiphlogistic drugs
- Analgesics
- Calcitonin
- Active movement exercises without exceeding the pain threshold
- Ergotherapy
- Physiotherapeutic exercise therapy
- Ergotherapy
- Balneotherapeutic measures (water gymnastics)
- Quengel bars if necessary
Calcitonin (peptide hormone) Calcitonin is a protein that is able to lower the calcium level in the body. Among other things, it slows down the release of calcium from bones, which occurs during bone resorption in the body. In Sudeck’s disease, calcitonin is said to have a positive influence on the course of the disease, especially in the early stages.
It is administered in the form of a nasal spray. It is administered subcutaneously or intranasally for 2-4 weeks at a dosage of 100-200 IU/day. AnalgesicsUse according to the WHO step-by-step scheme has proven successful.
Opioids (retard preparations) are frequently indicated Non-steroidal anti-inflammatory drugs (NSAIDs)Usually as adjuvant therapy as the analgesic component alone is not sufficient (e.g. diclofenac, iboprofen, Celebrex) Corticoidez. B. Metylprednisolone over 4-5 days 80mg in the acute stage and then over two weeks. Tricyclic antidepressants for pain relief Amitriptyline up to 150mg/day Sympathetic nerve block (nerve block)The aim of sympathetic nerve block is to relieve pain by eliminating the pathological irritation if the initial measures are unsuccessful and there is evidence of symmetrically maintained pain (initially diagnostic sympathetic block).
Radical scavengerLocally in the early stages as dimethysulfoxide (DMSO) in the form of a 50% cream (several times daily for 2-3 months). As an i.v. infusion, mannitol 10% (under the presumption of an acute inflammatory event) is administered 1000ml/24 hours over one week.
- Stellate ganglion
- Brachial plexus
- Plexus Lumbalis
- Blockage of the femoral nerve (femoral nerve)N. ischiadicus
