What is algodystrophy and what causes it?
Algodystrophy, or Complex Regional Pain Syndrome (CRPS), is a form of chronic pain that appears in the upper or lower limbs. It is an unusual syndrome that, in the majority of cases, manifests as a result of injury to the bones or joints, or after an orthopedic surgical operation that, for an unclear reason, causes dysfunction of the nervous system. The peripheral nerves responsible for the contraction of the arteries and capillaries around the joints are disturbed, and a lack of blood perfusion is observed in the affected area, resulting in the occurrence of pain.
A possible heart attack or stroke, vascular disorders, as well as intense stress, act as aggravating factors in algodystrophy.
What are the symptoms of the disease?
- Pain and a burning sensation in the affected area
- Allodynia, meaning the provocation of pain from a normally non-painful stimulus, e.g., touch
- Change in the color, texture, and temperature of the skin in the affected area
- Changes in hair and nail growth
- Joint stiffness, swelling
- Muscle spasms
- At an advanced stage, reduced ability or inability to move the affected limb
How is algodystrophy diagnosed?
Early diagnosis of algodystrophy is very important for the effective management of the disease, but it is often very difficult, given that its typical appearance occurs more than 2 weeks after the surgical operation or the injury. Delayed diagnosis and therefore delayed treatment are the main causes of the high percentage of chronic complications of the disease.
There is no specific diagnostic test for algodystrophy; therefore, healthcare professionals will request a detailed medical history and carry out tests to rule out other diseases with similar symptoms, such as arthritis. Depending on the symptomatology, tests performed for diagnosing the disease are:
- Blood tests
- Bone scintigraphy
- Magnetic Resonance Imaging (MRI)
- X-rays
- Specialized tests for investigating disorders of the sympathetic nervous system, e.g., thermography, electromyography
How is algodystrophy treated?
In some rare cases, the symptoms of Complex Regional Pain Syndrome subside on their own. In others, they may persist for months or even years, with negative effects on the patient’s daily life. There is evidence that if treatment begins within the first months of the symptoms, it may help improve the complex symptoms of peripheral pain.
Modern treatments for algodystrophy include medication, physiotherapy, interventions on the sympathetic ganglia, peripheral anesthesia, and aim at reducing pain and improving the patient’s motor functionality.
Often, a combination of different therapies, tailored to your personal needs, is necessary.
The Scientific Team of the Therapia Specialists, Pain & Personal Care Unit, staffed by experienced anesthesiologists, neurologists, neurosurgeons, physiotherapists, and alternative therapists, will evaluate each case individually and propose a personalized pain-management plan for each patient.
Alternative and combined approaches for Algodystrophy include:
- Administration of medication: analgesics such as aspirin for mild pain and inflammation; antidepressants and antispasmodics used for neuropathic pain; corticosteroids for reducing inflammation; osteoporosis medications; injection of anesthetic drugs to block nerves of the sympathetic nervous system; or intravenous ketamine for pain relief; and topical analgesics for reducing hypersensitivity such as capsaicin cream or lidocaine cream and patches.
- Physiotherapy: Mild exercise of the affected limbs is extremely beneficial for reducing pain and improving strength and movement. The earlier the diagnosis of the disease is made, the more effective physiotherapy can be.
- Transcutaneous Electrical Nerve Stimulation (TENS): low-frequency electrical currents that stimulate the sensory nerve fibers with analgesic effects.
- Biofeedback: Biofeedback is a non-invasive method that can contribute to relieving chronic pain. During biofeedback, the patient is connected to electrical sensors that help them receive information about their body. In this way, with the guidance of the physiotherapist, the patient learns to control certain bodily functions, such as relaxing certain muscles, to achieve the desired outcome—the reduction of pain. Essentially, biofeedback allows us to understand and control our body better, for the improvement of our health.
- Mirror therapy: A non-invasive, pioneering alternative method that works as an adjunct in cases of chronic, incurable pain… by tricking the brain! The affected limb is placed behind a mirror, while the reflection of the other limb—placed in front of the mirror and moving without difficulty—is observed. With this optical illusion, the brain believes that the affected limb is moving without pain; it receives false visual information and forms a new body map.
- Spinal cord stimulation: A minimally invasive method in which the doctor inserts microscopic electrodes along the spinal cord that deliver small electric impulses to relieve pain.
- Implantation of a drug pump: Also an invasive method, during which a permanent pump is implanted to deliver medication into the intrathecal space for pain relief.
- Psychological support: Because physical health can directly affect mental health, and because chronic conditions often bring feelings of anger or frustration, psychological support from specialists may at times be very important to help patients manage negative emotions and optimize treatment outcomes.
Did you know that…
- Algodystrophy is more likely to appear in women and smokers?
- Vitamin C may help prevent algodystrophy?
- Early diagnosis can ensure full recovery in 80–90% of patients?
