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Question
Posted by: Susan French | 2007/03/23

Sudecks Atrophy

Hi there
My daugher aged 15 (a twin), has been suffering from Sudecks Atrophy since 2005, currently she is spending half the year at home. I've been to the Pain Clinic, she has had three temporary blocks, have been to doctors, specialists and she has had dopplers, MRI, X Rays, blood tests and once again she is at home and not able to fully walk on her left leg. Generally it starts in her hip, moves down to the knee and then ankle, leg becomes cold and swollen in the joints. I don't know what to do anymore and would appreciate some advice.
Thank you

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Our expert says:
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Dear Susan
See these articles:
http://www.physioroom.com/injuries/supplements/sudecks_atrophy.php
http://www.virtualpaincentre.com/diseases.asp?did=356

Treatment includes tricyclic antidepressants, non steroidal anti-inflammatories (NSAIDs) and/or corticosteroids, Transcutaneous Electrical Nerve Stimulation (TENS) - you get a little machine for this.

Electro-acupuncture gave 70% improvement (G. S. E. Dowd, R. Hussein, V. Khanduja, and A. J. Ordman Complex regional pain syndrome with special emphasis on the knee J Bone Joint Surg Br, March 1, 2007; 89-B(3): 285 - 290. )

1: Clin Orthop Relat Res. 1987 Feb;(215):217-22. Links
Carbocalcitonin treatment in Sudeck's atrophy.Nuti R, Vattimo A, Martini G, Turchetti V, Righi GA.
The efficacy of new calcitonin, the amino analog of eel calcitonin (carboCT) on Sudeck's atrophy of the foot was investigated in 14 patients. CarboCT was administered at the dose of 40 Medical Research Council (MRC) units per day, and the duration of treatment was two to ten months. No adverse effects were noted. Bone pain and local edema decreased associated with improvement of motility. CarboCT induced a slight decrease in plasma calcium, plasma phosphate, and 24-hour urinary calcium excretion. An increase in cAMP/Cr ratio, an index of parathyroid function, was also observed (probably a manifestation of the hypocalcemic effect of calcitonin and secondary parathyroid stimulation). The whole body retention of 99mTc-MDP represents a valuable index of bone turnover, it decreased progressively and significantly on treatment. A dynamic study of local bone uptake of 99mTC-MDP was performed in eight patients. After carboCT therapy, statistically significant decreases in local blood flow, early uptake, and delayed uptake were appreciated in the involved foot. These findings lead to the conclusion that carboCT is effective in the treatment of Sudeck's atrophy.

Let me know if any of these make a difference! You will probably have to find a neurologist or orthopod willing to spend the time to experiment with different treatments.


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