Sudeck syndrome: symptoms, causes and treatment

Within the infinite list of known rare diseases, there are some as mysterious to the scientific community as Sudeck's syndrome, whose first record dates from 1864.

Throughout this article we will describe what this strange syndrome consists of that causes immense pain in those who seem to be. Likewise, we will talk about its symptoms, its possible causes and its treatment.

• Related article: "The differences between syndrome, disorder and disease"

What is Sudeck syndrome?

Sudeck's disease, also known as complex general pain syndrome (CRPS), It is a disease characterized by being quite painful affecting one or more extremities of the body.

This condition tends to originate after some type of injury or operation, and is distinguished by being a syndrome, multisymptomatic and multisystemic. The degree of pain and the evolution of Sudeck's syndrome does not have to correspond to the magnitude of the injury that triggers it.

It is vital that this rare syndrome is diagnosed at the earliest possible stage. Otherwise,

could end up spreading to all extremities, making his recovery much more painful and difficult.

Given the high levels of pain caused by this disease, the person may become manifest serious psychological alterations, pharmacological dependence or even develop a complete disability.

Another factor that makes this disease so disabling for the person who suffers from it is that its course is completely unpredictable and can vary exaggeratedly from one person to another.

• Related article: "The 13 types of pain: classification and characteristics"

Symptoms and clinical picture

As mentioned above, Sudeck's disease has a wide variety of clinical features. These symptoms include pain or changes in the skin and bones. Next, we will describe each of these clinical symptoms:

1. Pain

This syndrome has the uniqueness that the person experiences pain of disproportionate proportions compared to the magnitude of the injury or damage that causes them.

In addition, it can be accompanied by mobility difficulties that appear after the injury. One of the first symptoms to appear in Sudeck syndrome patients is severe, constant, deep, burning pain.

Finally, any type of touch, whatever the intensity, is experienced as a painful sensation of the highest level.

2. Skin changes

The dermis may present symptoms of dystrophy or atrophy, as well as dryness with or without desquamation. Likewise, the abnormal sympathetic activity that causes this disease may be related to changes in skin pigmentation, skin temperature, and sweating levels.

3. Bone alterations

Sudeck syndrome can lead to bone wasting or osteoporosis in the joints. This wear and tear can be seen through x-rays and bone scans.

4. motor affections

People affected by this disease experience Great difficulty performing any type of movement. These difficulties are caused by the intense pain they experience due to increased muscle tone.

As a consequence, patients tend to decrease their movements, thus generating diffuse muscular atrophy. Other motor symptoms are tremors or involuntary reflex movements.

5. Inflammation

In most cases, patients present localized inflammation in the place where the pain is generated.

All of these symptoms tend to be localized to the injury site. However, as the disease evolves, all these symptoms will begin to spread. There are 3 patterns that describe the spread of the disease:

• Continuous type pattern: symptoms spread upward. For example, from the wrist to the shoulder.
• Mirror Image Type Pattern: Propagation towards the opposite extremity.
• Independent type pattern: in this case the symptoms extend to a distant part of the body.

Causes and risk factors

The causes of Sudeck's disease are currently unknown. therefore still it is not understood why the sympathetic system is constantly in hyperactive mode.

Some theories hypothesize that this hyperactivity causes an inflammatory response that causes constant spasms at the site of injury. Also, these spasms can cause the pain to increase more and more, thus becoming a continuous cycle of discomfort.

Although the causes are unknown, there are a number of risk factors associated with Sudeck syndrome. These are:

• previous surgeries
• infections.
• spinal disorders.
• Idiopathic disorders.
• neurological injuries both central and peripheral.
• Cardiovascular diseases.
• previous trauma, repetitive trauma or repetitive motion disorders.

Diagnosis

Since there are no specific diagnostic tests for Sudeck syndrome, a differential diagnosis is necessary in which any other disorder with similar symptoms is ruled out.

As a result of this, the diagnosis will be made mainly by observing signs and symptoms. Some of the tests that can be carried out to try to diagnose this disease are:

1. x-rays

Through the use of radiographs it is possible to identify a kind of speckled osteoporosis characteristic of this syndrome.

2. Nuclear magnetic resonance

This is a useful test for early detection of Sudeck's syndrome, especially when the lesion is located at hip level.

3. thermography

Thermography is a test in which, by using a specialized camera, can measure the heat emitted by the body.

4. Laboratory analysis

Blood and urine tests will assess the presence of hypertriglyceridemia, hyperuricemia, hypercalciuria, and hydroxyprolinuria.

Treatment

The most important goal in the treatment of Sudeck syndrome is getting the patient to use the affected limb.

Through the use of medications, physical therapy or nerve blocks, it is intended to reduce the pain. In addition, intervention with physiotherapy will teach the patient to use their affected limb in their day-to-day activities.

Physical exercises such as swimming or any other aquatic activity have shown to be highly effective in patients affected by the lower extremities.

Psychological support is of vital importance in the treatment of Sudeck syndrome. Your goal is reinforce the mental or psychological aspects of the illness, as well as motivating the patient to carry out pain management techniques.

If this treatment can be carried out during the early stages of the disease, the probability of complete remission is approximately 85%. In cases where the disease does not receive adequate treatment, it can lead to becoming chronic.