sudecks atrophy

[floracat79]

Hi can anyone help please.
I am living in Cyprus. 3rd march fell and had collees fracture.
After 4weeks pop came off as had cellulitis, or so it seemed.
Now been diagnosed with sudecks atrophy. Hand like a claw, very swollen, can't move fingers. horrendous pain.
Have just started physio.I passed out with the pain. Basically physio just forced fingers and wrist to move.
How would this condition be treated in UK / USA please thanks

floracat79

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[gcoe]

Hi floracat79

I don't work in the US or the UK but NZ is not a backwater when it comes to physioherapy so here is a response.

Sudecks Atrophy, Reflex Sympathetic Distrophy and Complex Regional Pain Syndrome type 1 (CRPS1) are all different names for the same problem with CRPS being the most up-to-date name . It is a rather baffling chronic pain syndrome that is not well understood. However it is a very distressing condition and can be quite disabling as you yourself are finding.

Here is some up-to-date information, provided by the NIH in the US.

Complex Regional Pain Syndrome Fact Sheet: National Institute of Neurological Disorders and Stroke (NINDS)

Have just started physio.I passed out with the pain. Basically physio just forced fingers and wrist to move.

This sounds pretty primitive, ineffective and just plain cruel. I can understand you not being too happy about going back for more. A big part of the problem is dealing with the pain which is out of all proportion to the rest of the problem. Getting good medical management for pain is part of it. A number of medications are available that target neuropathic pain and this could be a useful strategy. You need to see a doctor with experience and training in managing chronic pain syndromes

The physio should aim to get you moving and using your hand but this needs to be graded with what can be tolerated. It is important to have a physio who understands what you are going through and is sympathetic and helpful. In our country there are specialised hand therapists that can be a good option as they often carry a high caseload of hand injuries that have developed into CRPS. To be honest effective physiotherapy may not be comfortable all the time but If you have a symptathetic and responsive physio who is used to managing these problems this can go along way to helping you cope with the pain and getting that hand moving again.

There is a number of physio approaches that have been tried but a physiotherapy technique called Graded Motor Imagery has good evidence for being effective with CRPS, based on clinical trials. At this stage it is the technique with the best evidence by far. . Here are a couple of websites that discuss Graded Motor Imagery. I can send you some information on the evidence for this technique if you like


NOI - Graded motor imagery

An Exciting Treatment for Pain: Graded Motor Imagery | How To Cope With Pain Blog

Graded motor imagery - Google Search

[floracat79]

Hi GCOE I am so glad you replied. I have looked at the links and the mirror box idea certainly sits well with me.
I have started doing my own set of exercises using both hands which certainly changes the balance of thought! I am going to get my hubby to create box asap.
Basically I am doing amix of movements including stretching as far as the hand will allow. I am not forcing anything but gently encouraging more range.
thanks so much i am going to look for a physio who majors in hands specifically. Thanks a million floracat..........