Treatment and symptoms of sudeki in the acute and chronic stages
Sudaca syndrome — pain that occurs after injuries of the extremities
Syndrome sudaka – a kind of neuropathic pain, a pathological condition caused by damage to soft tissue, nerves, joints or bones.
The disease is accompanied by osteoporosis (bone atrophy), restrictions of mobility in the joints, impaired blood flow and associated trophic effects.
Disease was first presented and described by the German surgeon P. Sudekum in 1900
He noted that the radiographic images in some inflammatory processes in bones and joints with subsequent atrophy is present the transparency of the bone figure, this phenomenon is called acute treponemataceae atrophy.
The causes of the disease
The most common cause of the disease is a complication after trauma or fracture of a limb, incorrect treatment or immobilization of a brush (full rest), damaged nerves or the sympathetic nervous knots.
Poor bandaging, painful manipulation, the acceptance of swelling, immobility of the joint can gradually lead to the development of the syndrome sudeka.
A certain place in the formation of the border States have vegetative — vascular disorders, hormonal disorders and cancer. Most women suffer after the age of 40, although cases of development of syndrome in men.
The cause of the pathological state are also called fractures:
- the radius is about 62%;
- lower extremities – 30%;
- humerus – 8%.
Elderly and middle-aged people are more likely to suffer the syndrome of the upper extremities, but children with lower.
The clinical picture
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Any injury accompanied by disturbances of the vasomotor mechanism and the autonomic nervous system.
With proper treatment, all the negative manifestations gradually pass, and there comes the healing process.
Otherwise bog increases with the slightest movement or touch.
There are three clinical stages of the syndrome sudaka, each of which is characterized by their symptoms:
- I – acute form. Is characterized by intense, burning pain, edema of the injured extremity. Pain syndrome is not removed by traditional analgesics. The temperature rises at the site of injury, the joints logopedija. Duration – up to 6 months;
- II – dystrophic stage. The temperature gradually decreases, the swelling subsides a bit also. The pain is constant shape, but of smaller intensity. The tendons thicken, begins to develop osteoporosis.
- III – atrophic stage. Skin becomes cyanotic in color (marble), becomes cold, much thinner. Degeneration of soft tissue and osteoporosis lead to tissue atrophy. The pain in this period is virtually nonexistent. Lose gradually covers the skeletal system, resulting in the hardening of the joints, fibrosis sliding apparatus of the tendon, rarefication bones. Duration – 6 to 12 months after injury.
In the later stages of the disease in 20% of patients develop sudden muscle weakness. Spotty osteoporosis, detected in 80% of patients in the early stages, long-term course of the disease passes into the diffuse.
The disease is in stage I and II development is easy to stop and the patient can get better fast enough.
Grade III is chronic and is characterized by atrophy of the tissues, which complicates the healing process.
With proper treatment, the mobility of the joint is restored only partially.
Syndrome treatment sudecka in the acute stage includes:
- immobilization of the limb 12 to 14 days by the physician;
- applying cold to the affected area;
- acupuncture in combination with ultrasound reflex zones of the limb;
- magnetic therapy;
- the interference –therapy.
Drug treatment is usually conservative. The specialist assigns a vasodilator and analgesic drugs, vitamins of group b, the CA antagonists, muscle relaxants, α – adrenergic blockers.
In more serious cases may require professional help of a psychologist. According to testimony carried a short course of antipsychotics and antidepressants, corticosteroids.
If pathogenetic treatment does not bring results, the intensity of pain persists, the patient is offered surgical intervention. Involves the sympathetic blockade: an introduction to nerve intravenous regional, pokanevych drugs, as well as infiltration anesthesia.
In the absence of allergic reactions, topically make the application on the basis of hot pepper, use the ointment «Espol», «Nikofleks».
In advanced cases, shows the arthrodesis of joints, slow stretching of the portion of the patient, an osteotomy of the distal radius metaepiphysis and other operations.
Therapy requires a long and complex approach. The duration of treatment depend on the stage and complexity of the disease, age of the patient, the effectiveness of treatment measures, ranging from 6 months to a year.
For stage I and II disease in the first weeks of development of complications, the prognosis is reasonably favorable.
Stage III is characterized by a more complicated prognosis, with the progression of the disease often unfavorable, as in the tissues began irreversible.
Despite the wide Arsenal of measures for the treatment of syndrome sudeki remains a complex disease with unclear until the end of the pathogenetic mechanism, which complicates treatment.
Full recovery is possible with early treatment to specialists and occurs usually at 6 months after initiation of therapy. In some patients may persist long enough to light restrictions, violations of work function of the limb.
Specific preventive measures when algoneurodystrophy does not exist. Experts advise to pay attention to their health, not to postpone the visit to the doctor and at the first signs of distress to seek help.
Only if timely treatment to the clinic has a chance to return to a normal lifestyle and completely restore the function of damaged limbs.
During rehabilitation, you need to be careful to intense heat treatments, avoid rough massage events. Allowed LFK, Spa treatment with radon baths, gravitational therapy.
The development of pathological syndrome may be interrupted at any stage, but the frequent outcome of the disease – fibrous ankylosis in a stable decompensation, which leads in most cases to disruption of normal life and disability.
Full recovery occurs only when a timely appeal to the specialist and the compliance with all therapeutic interventions aimed at the regeneration of bone pain and prevention of progression of atrophy.