From Morbus Sudeck to complex regional pain syndrome.
Summary of "From Morbus Sudeck to complex regional pain syndrome."
Burning pain and autonomic disorders, such as change of skin color, hyperhidrosis, edema and stiffness in joints of extremities were first described in 1864 by Silas W. Mitchell. The German expression "Morbus Sudeck" takes its name from the surgeon Paul Sudeck from Hamburg who described spotty decalcification in x-rays in 1900. In the Anglo-Saxon world, the theory that the sympathetic nervous system was involved in the generation and sustention of these alterations was based on the observations of the French surgeon René Leriche and in 1846 James A. Evans introduced the expression sympathetic reflex dystrophy. As doubts arose that the sympathetic nervous system could not be the sole culprit, the descriptive phrase of complex regional pain syndrome was introduced to substitute for more than 60 synonyms focusing on the fact that the disease develops after minor trauma or nerve lesions and does not correlate with the severity of the trauma. Diagnosing this syndrome is still hampered by the fact that no specific laboratory or radiological marker has yet been identified. Multidisciplinary and interdisciplinary approaches to therapy seem to be inevitable. Since Sudeck first described the disease, 110 years have passed. The underlying hypothesis and theories as well as the development during this time period are summarized.
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This article was published in the following journal.
Name: Schmerz (Berlin, Germany)
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21350971
- DOI: http://dx.doi.org/10.1007/s00482-011-1020-9
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Medical and Biotech [MESH] Definitions
Conditions characterized by pain involving an extremity or other body region, HYPERESTHESIA, and localized autonomic dysfunction following injury to soft tissue or nerve. The pain is usually associated with ERYTHEMA; SKIN TEMPERATURE changes, abnormal sudomotor activity (i.e., changes in sweating due to altered sympathetic innervation) or edema. The degree of pain and other manifestations is out of proportion to that expected from the inciting event. Two subtypes of this condition have been described: type I; (REFLEX SYMPATHETIC DYSTROPHY) and type II; (CAUSALGIA). (From Pain 1995 Oct;63(1):127-33)
A complex regional pain syndrome characterized by burning pain and marked sensitivity to touch (HYPERESTHESIA) in the distribution of an injured peripheral nerve. Autonomic dysfunction in the form of sudomotor (i.e., sympathetic innervation to sweat glands), vasomotor, and trophic skin changes may also occur. (Adams et al., Principles of Neurology, 6th ed, p1359)
An old term that is no longer used in the scientific literature. Cholera morbus refers to acute GASTROENTERITIS occurring in summer or autumn; characterized by severe cramps, diarrhea, and vomiting.
A syndrome characterized by retropatellar or peripatellar PAIN resulting from physical and biochemical changes in the patellofemoral joint. The pain is most prominent when ascending or descending stairs, squatting, or sitting with flexed knees. There is a lack of consensus on the etiology and treatment. The syndrome is often confused with (or accompanied by) CHONDROMALACIA PATELLAE, the latter describing a pathological condition of the CARTILAGE and not a syndrome.
Complex pain syndrome with unknown etiology, characterized by constant or intermittent generalized vulva pain (Generalized vulvodynia) or localized burning sensations in the VESTIBULE area when pressure is applied (Vestibulodynia, or Vulvar Vestibulitis Syndrome). Typically, vulvar tissue with vulvodynia appears normal without infection or skin disease. Vulvodynia impacts negatively on a woman's quality of life as it interferes with sexual and daily activities.