This disease is characterized by being very painful and by affecting one or more limbs.
Within the infinite list of known rare diseases, there are some as mysterious to the scientific community as Sudeck syndrome, whose first record dates back to 1864.
Throughout this article we will describe what this strange syndrome consists of, which causes immense pain in those who seem it. We will also talk about its symptoms, its possible causes and its treatment.
What is Sudeck syndrome?
Sudeck’s disease, also known as complex general pain syndrome (CRPS), is a disease characterized by being quite painful that affects one or more body extremities.
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 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 stage possible. Otherwise, it could end up spreading to all limbs, making your recovery that much more painful and difficult.
Given the high levels of pain caused by this disease, the person can manifest serious psychological disorders, drug dependence or even develop complete disability.
Another factor that makes this disease so disabling for the person who suffers it is that its course is totally unpredictable and can vary exaggeratedly from one person to another.
Symptoms and clinical picture
As mentioned above, Sudeck’s disease has a wide variety of clinical features. This symptomatology includes pain or changes in the skin and bones. We now describe each of these clinical symptoms:
This syndrome is unique in 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 friction, 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 can be related to alterations 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 can be seen on x-rays and bone scans.
4. Motor conditions
People affected by this disease experience great difficulties to perform 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 slow down their movements, thus generating diffuse muscle atrophy. Other motor symptoms are tremors or involuntary reflex movements.
In most cases, patients present localized inflammation in the place where the pain is generated.
All of these symptoms tend to be localized at the site of injury. 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 extend upward. For example, from the wrist to the shoulder.
- Mirror image pattern: spread to the opposite limb.
- Independent pattern: in this case the symptoms spread to a distant area of the body.
Causes and risk factors
The causes of Sudeck’s disease are currently unknown. Therefore, it is not yet 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 that are associated with Sudeck syndrome. These are:
- Previous surgeries
- Spinal disorders.
- Idiopathic disorders
- Both central and peripheral neurological lesions.
- Cardiovascular diseases.
- Previous trauma, repeat trauma, or repetitive motion disorders.
Since there are no specific diagnostic tests for Sudeck syndrome, it is necessary to perform a differential diagnosis in which any other disorder with similar symptoms is ruled out.
Following 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:
Using X-rays, a class of mottled osteoporosis characteristic of this syndrome can be identified .
2. Nuclear magnetic resonance
This is a useful test for the early detection of Sudeck syndrome, especially when the lesion is located at the level of the hip.
Thermography is a test in which the heat emitted by the body can be measured by using a specialized camera .
4. Laboratory analysis
Through blood and urine tests, the presence of hypertriglyceridemia, hyperuricemia, hypercalciuria and hydroxyprolinuria will be evaluated .
The most important goal in treating Sudeck syndrome is to get the patient to use the affected limb.
Through the use of medications, physical therapy or nerve blocks, it is intended to reduce the pain. Likewise, the intervention with physiotherapy will teach the patient to use his affected limb in his daily activities.
Physical exercises such as swimming or any other aquatic activity have been shown to be highly effective in patients with lower extremities.
Psychological support is of vital importance in the treatment of Sudeck syndrome. Its objective is to reinforce the mental or psychological aspects of the disease, as well as to motivate 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.