CRPS/ (complex regional pain syndrome)/ Sudeck’s Atrophy/ Causalgia/Algodystrophy
This condition usually starts following a minimal trauma due to an external influence, a bone breakage, operations and inflammations that lead to a change that is visible externally – dystrophy (faulty growth) and atrophy (wasting away of tissue) of parts of the limbs.
In almost 80 % of patients, there is an accompanying weakness in the extremity affected, which initially manifests itself as pain and oedema, and leads to muscle contracture and fibrosis if it reaches a chronic stage. In addition to hyperaesthesia, an increased sensitivity to pain stimuli, pain can also be caused by contact alone, which is referred to as allodynia. Most patients experience a burning or tingling rest pain. The skin is almost always swollen, hot and red, and half of patients experience excessive sweating (hyperhidrosis). Only after a long period of time does the skin turn blue and feel cold.
Adult women are the most likely to be affected, with the arms affected more often than the legs. It is not yet known for sure why CRPS occurs; it is thought that the cause is inflammation of the nerves under the skin and in the brain, coupled with a restructuring of the outer layer of the brain – the cerebral cortex.
Therapy involves the use of painkillers (analgesics) such as opioid and non-opioid analgesics. Furthermore, in the case of accompanying bone diseases that show up as spots on the X-ray, bisphosphonates are also administered in addition to local anti-inflammatory medicines. If neither occupational therapy nor physiotherapy leads to an improvement, it may be possible to alleviate pain by injecting local anaesthetics into the autonomic nervous system – a sympathetic block.
If the pain continues, we will implant neurostimulators (SCS and ganglion stimulators). We have already helped many patients that have been living with these implants for years, and that are able to independently adjust the level of painkillers they use to how much they need.