Algodystrophy is a progressive disease, usually originating in the hands, where 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 may 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 why this condition develops are not clear. It usually occurs in response to trauma, but it can be difficult to predict what type of trauma will lead to algodystrophy. The condition begins with tingling in the hand that slowly radiates down the arm. The skin often becomes red and irritated, and patients begin to experience severe joint pain. Nerve damage sometimes occurs, and patients may develop areas of grayish skin caused by poor oxygenation.
Over time, algodystrophy can cause contractures, where the muscles tighten. This can cause the hand to begin to curl in on itself. The patient will have trouble straightening the fingers and may lose the use of the hand altogether. Contractures can also be very painful. Bone and cartilage growth will be interrupted and the patient's hand and arm often begin to waste away, greatly diminishing in size in some cases. The knuckles and joints may swell as a result of the inflammation, and the hand may take on a knobby, gnarled appearance.
Treatment may include pain management medications to treat the pain of the condition. Algodystrophy can also be treated with anti-inflammatory medications to reduce swelling and make the patient more comfortable. This may include steroid injections at the site. Physical therapy is sometimes helpful in retaining as much use of the affected arm as possible. Some patients also benefit from treatments such as electrical nerve stimulation to interrupt pain signals or surgeries to cut key nerves if pain does not respond to other treatments.
If a patient appears to be developing algodystrophy, a doctor will usually order some screening tests. This is done to rule out conditions like cellulitis and other infections, which can cause similar symptoms at first. Medical imaging studies can be helpful in detecting joint inflammation as well as changes in 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 another disease is the cause of the pain.