Algodystrophy is a rare multi-symptomatic disease. It causes intense and continuous pain, localised in the lower or upper limbs and generally associated with oedema.
This condition could originate from a malfunction of different body systems, such as the nervous, circulatory and immune systems.
According to experts there are two types of algodystrophy:
- algodystrophy I, also known as “complex regional pain syndrome I”
- algodystrophy II, or “complex regional pain syndrome II”
In cases where the disease was preceded by an injury to the nervous system, it is called algodystrophy II, in all the others cases it is referred to as algodystrophy I.
In literature we sometimes refer to algodystrophy as Sudeck’s Atrophy.
Before focusing on its causes and its symptoms, let’s take a look at the parts of the body most commonly affected by this syndrome.
As already mentioned, algodystrophy mainly affects the lower and upper limbs.
In terms of the former, the most common forms include algodystrophy of the knee and the hip, but in many cases Sudeck’s Atrophy also affects the foot and ankle.
When it is located in the upper limbs, algodystrophy mainly affects the hand.
As previously mentioned, experts claim that the origin of algodystrophy may derive from a malfunction of the central and peripheral nervous system, the immune system and the blood circulatory system, which includes all the arteries and veins that carry blood.
This stems from the fact that this condition affects the functions controlled by these three systems.
Despite this, the causes remain largely unknown.
There are, however, risk factors that increase the chances of becoming afflicted with this disease.
It has been found that in more than 90% of cases algodystrophy affects individuals who have suffered bone fractures, cuts, sprains and pulled joints, burns and scalds.
It is difficult to diagnose algodystrophy because the symptoms are not very specific and may resemble those of other diseases and conditions.
Despite this, the presence of pain in a specific and circumscribed region is a signal that can guide the doctor towards the diagnosis of algodystrophy.
After which, any further symptoms and the presence of previous trauma are evaluated, which can help arrive at the diagnosis.
For example, one of the most common signs is changes in the skin, which becomes paler, dry and atrophic.
The symptoms of algodystrophy can be detected by an x-ray or, if they are more restricted to a single area, by an MRI scan or a triphasic scintigraphy.
The scintigraphy is certainly the most appropriate examination because it is able to detect even minor bone changes compared to a radiographic examination.
Nevertheless, one drawback is due to the fact that the scintigraphic picture varies according to the different stages of the disease.
In addition to those already mentioned, blood tests and nerve conduction studies can be performed, in order to exclude, respectively, the presence of infectious diseases and nerve damage.
Therefore, no specific diagnostic test is envisaged and despite the possibility of using these instruments, the diagnosis of algodystrophy is predominantly clinical.
Physical therapy involves the execution of physiotherapy exercises for the treatment and rehabilitation of the hand, hip, knee, foot and limbs in general.
There is no specific treatment for algodystrophy and therapy includes treatments that have the sole purpose of alleviating the symptoms of the disease (symptomatic therapy).
As a result, it is not possible to talk about healing times for those suffering from algodystrophy.
The three main types of therapy are looked at below.
Physical therapy involves the performance of physiotherapy exercises for the treatment and rehabilitation of the hand, hip, knee, foot and limbs in general.
These exercises are intended to improve blood circulation, joint mobility, muscle strength and elasticity.
With regard drug therapy, on the other hand, doctors can prescribe a whole host of drugs:
- Non-steroidal anti-inflammatory drugs (NSAIDs): they are used to relieve pain by tackling inflammation
- Corticosteroids: these are anti-inflammatory drugs that should be taken in moderation because their side effects include the onset of other diseases such as osteoporosis and diabetes.
- Tricyclic antidepressants
- Opioids (e.g.: morphine): they are very powerful analgesics.Once again, as with corticosteroids, they should be taken in moderation because they can cause side effects like nausea and vomiting, fatigue, cognitive problems and depression.
- Local anaesthetics: they are used in the form of creams
Finally, psychological therapy, also called psychotherapy, is recommended by doctors to all people who have developed depression, anxiety or other psychological disorders resulting from the onset of algodystrophy.
There are other less commonly used ways to treat algodystrophy, such as:
- Blocking the sympathetic nervous system: this involves the injection of an anaesthetic near the spinal cord, in order to stop the activity of one or more nerves of the sympathetic nervous system.It is not effective in the long run, but it may be useful to temporarily reduce pain.
- Sympathectomy: a structure of the sympathetic nervous system is surgically removed.
- Spinal cord stimulation: the cord is stimulated by a number of electrodes attached to the vertebral column.
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