Causalgia is a strong, burning pain, accompanied by trophic, motor, vasomotor disorders. Usually it occurs when peripheral nerves are affected. Pathology proceeds with sensory disturbances, such as hyperpathy, allodynia, hypersthesia. To determine whether causalgia is a condition or another, the doctor conducts a series of diagnostic procedures, among which ENMG is mandatory. These methods can help identify the causes of pain. The state is treated comprehensively.
Pathological condition
Causalgia is a pathological condition discovered in 1855 by Pirogov. At that time, pain of this nature was called "traumatic hypersthesia." After almost ten years, the state began to be called "causalgia." Over the years, the name was proposed to be replaced by a more precise wording - a complex regional pain syndrome or CRPS.
Causes of occurrence
Causalgia is a pain syndrome that occurs when nerve endings are damaged as a result of trauma to the limbs. According to statistics, in about 80% of cases, the pain syndrome occurs due to various injuries, surgical intervention. An additional factor in the development of pain is the application of a tight dressing, gypsum. CRPS can occur as a result of damage to the peripheral nerve trunk, as well as a result of the following reasons:
- Nerve damage. The syndrome occurs as a result of concussions, partial or complete ruptures, with contusion. Injury to the nerve occurs with fractures, wounds, dislocations, surgery. With a complete break, the pain syndrome manifests itself as phantom pains.
- Tunnel Syndrome. Causalgia occurs due to compression of the nerve by bone formations, muscles, and ligaments. If vascular bundles are located nearby, then the pathology proceeds according to the type of ischemia.
- Radiation therapy. Nerve tissue is highly sensitive to radiation therapy, which can be damaged.
- Violations of the vascular system. Vein thrombosis, atherosclerosis, endarteritis, vasculitis and other pathologies gradually lead to damage to the nerve trunk. As a result of developing circulatory failure, ischemic neuropathy appears.
- Various infectious diseases. HIV, herpes, diphtheria and a number of other infections occur with involvement of the nerve trunks in the pathological process. Due to the changes that occur, causalgia occurs.
Classification
Symptoms and treatment of causalgia depend on the classification of the disease. In accordance with it, the condition is divided into proximal, common and distal. The development of the syndrome takes place in several stages.
The acute stage lasts about six weeks. It is characterized by constant pain, swelling, redness of the limb.
The dystrophic stage lasts from the sixth week to six months. A characteristic manifestation is increasing pain, hypertrophy, hyperkeratosis of the skin, elasticity decreases. From the sixth month, tissue atrophy, dry limbs are observed. Pain at this stage is practically absent.
Clinical manifestations
Symptoms of causalgia add up from trophic, vasomotor and pain manifestations. At the initial stage, burning pain is felt. It can be triggered by any irritant, including touch. The intensity of the pain syndrome can be different. When the limbs are moistened, the pain subsides. This is a characteristic symptom of causalgia.
Also, pathology is characterized by hyperpathy, allodynia, hyperalgesia. If a violation of motor activity occurs, edema appears, the skin pattern is smoothed.
When revealing vegeto-trophic changes, a local increase in temperature is observed, the growth of hair and nails is accelerated. Also noted cyanotic pallor, anhydrosis. Such manifestations are observed for about six months, then there is a restriction of movement, muscle degeneration. In some cases, tremors, convulsions, a feeling of stiffness during movement are noted.
Therapies
Causalgia is treated with combined methods, including exercise therapy, drug therapy, kinesiotherapy, psychotherapy and other methods. In the acute phase of the pathology used:
- anti-inflammatory drugs - the doctor selects non-steroidal anti-inflammatory drugs, and in severe cases - glucocorticosteroids;
- painkillers - for moderate manifestations of pathology, non-narcotic painkillers are prescribed, and in severe cases - narcotic;
- osteoporosis is being treated;
- antidepressants, anxiolytics that relieve anxiety, irritability, anxiety are selected;
- physiotherapy is performed to reduce pain.
Each patient is prescribed exercise therapy. In the dystrophic phase, hydrokinesiotherapy, mud therapy, radon baths are recommended. In severe cases, surgery is performed in the form of a sympaectomy.