Algodystrophy is a progressive disease, usually originating in the hands, where the bone, tissue, and skin undergo painful changes in response to trauma. It is also known as complex regional pain syndrome (CRPS), algesidystrophy, or reflex sympathetic dystrophy. Patients with this condition can experience permanent impairments as a result of muscle contractures and pain associated with algodystrophy. Treatment options are available, although the condition cannot be cured.
The reasons this condition develops are not clear. It usually occurs in response to trauma, but it can be hard to predict what kinds of trauma will lead to algodystrophy. The condition starts with tingling pain in the hand that radiates slowly up the arm. The skin often becomes red and irritated, and patients start experiencing severe joint pain. Sometimes, nerve damage occurs and patients may develop areas of grayed skin caused by poor oxygenation.
Over time, this condition can cause contractures, where the muscles pull up short. This can cause the hand to start curling in on itself. The patient will have trouble straightening the fingers and may lose use of the hand altogether. The contractures can also be very painful. Bone and cartilage growth will be disrupted and the patient's hand and arm often begin to waste, shrinking down in size considerably in some cases. The knuckles and joints may swell as a result of inflammation, and the hand may take on a gnarled, knobbly appearance.
Treatment can include pain management medications to address the pain of the condition. Algodystrophy can also be treated with anti-inflammatory drugs to reduce swelling and make the patient feel more comfortable. This can include steroid injections into the site. Physical therapy is sometimes helpful for retaining as much use of the affected arm as possible. Some patients also benefit from treatments like electrical nerve stimulation to disrupt pain signals or surgeries to sever key nerves if the pain doesn't respond to other treatments.
If a patient appears to be developing this condition, a doctor will usually order some screening tests. This is done to rule out conditions like cellulitis and other infections, which may cause similar symptoms in the beginning. Medical imaging studies can be useful for spotting joint inflammation, as well as changes to the bones and joints. Careful diagnostic evaluation is important, as the approach to treatment will change if the condition is not algodystrophy, and it may be possible to cure the patient if the cause of the pain is another disease.
