• Sudeck's healing derailment
  • Algodystrophy
  • Causalgia
  • Sudeck syndrome
  • Post-traumatic dystrophy
  • Complex Regional Pain Syndrome
  • Complex regional pain syndrome I and II
  • Reflex sympathetic dystrophy
  • Sudeck's disease

English: Complex Regional Dysfunction System

Overview of forms of therapy

There is no generally recognized therapy concept. The therapy depends on the stage of the disease. The following stage-dependent therapeutic approach is recommended.

Stage I.

  • Immobilization of the affected extremity in the functional position
  • Analgesics (pain relievers)
  • physical therapy with Lymphatic drainage and active movement exercises
  • Electrotherapy
  • Corticoids
  • nonsteroidal anti-inflammatory drugs (NSAIDs e.g. Diclofenac, Iboprofen®)
  • Calcitonin (Karil®)
  • in individual cases symphatikolysis through blockade of the trunk
  • Massages and passive movement exercises are contraindicated!

Stage II

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  • anti-inflammatory drugs
  • Analgesics
  • Calcitonin
  • active movement exercises without exceeding the pain threshold
  • Occupational therapy

Stage III

  • physiotherapeutic exercise therapy
  • Occupational therapy
  • Balneotherapy measures (water aerobics)
  • possibly whine splints
Appointment with a hand specialist?

I would be happy to advise you!

Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

In order to be able to treat successfully in orthopedics, a thorough examination, diagnosis and a medical history are required.
In our very economic world in particular, there is too little time to thoroughly grasp the complex diseases of orthopedics and thus initiate targeted treatment.
I don't want to join the ranks of "quick knife pullers".
The aim of any treatment is treatment without surgery.

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Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me at:

  • Lumedis - orthopedics
    Kaiserstrasse 14
    60311 Frankfurt am Main

Directly to the online appointment arrangement
Unfortunately, appointments can only be made with private health insurers. I ask for understanding!
Further information about myself can be found at Lumedis - Dr. Nicolas Gumpert

Medical therapy

Calcitonin (peptide hormone)

Calcitonin is a protein that is able to increase calcium levels in the body reduce.
Among other things, it slows down the release of calcium from bones, which occurs during Bone loss takes place in the body.

Calcitonin becomes special in Sudeck's disease in the initial stages attested a positive influence on the course. It is given in the form of a nasal spray.

It is administered subcutaneously or intranasally over a period of 2-4 weeks at a dosage of 100-200 IU / day.

Use according to the WHO level scheme has proven itself. Opioids (slow-release preparations) are often indicated

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Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
Usually as adjuvant therapy because the analgesic component alone is not sufficient (e.g. Diclofenac, Iboprofen, Celebrex)

e.g. Metylprednisolone 80mg for 4-5 days in the acute stage and then tapered off for two weeks.

Tricyclic antidepressants
for pain relief amitriptyline up to 150mg / day

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Sympathetic blockade (nerve block)
The aim of the sympathetic block is to relieve pain by eliminating the pathological irritation if the initial measures are unsuccessful and the presence of a sympathetically maintained pain is proven (initially diagnostic sympathetic block).

  • Stellate ganglion
  • Brachial plexus
  • Lumbar plexus
  • Blockade of the femoral nerve (Femoral nerve) / Sciatic nerve

Radical scavengers
Locally in the early stages as dimethysulfoxide (DMSO) in the form of a 50% cream (several times a day for 2-3 months). Mannitol 10% is administered as an IV infusion (assuming an acute inflammatory process) 1000 ml / 24 hours over a week.

physical therapy

One possible treatment for Sudeck's disease is physiotherapy.

Physiotherapy can, however not in the "high phase" Disease occur when the affected area is affected by swelling, redness, and pain.
In this case, physiotherapy is one Elevation and immobilization preferable.

If the symptoms have improved, you can use cooling and "Descending baths" to be started.
These are bathrooms that are set to approx 1-2 degrees below core body temperature are tempered, and are lowered by another 1-2 degrees every 15 minutes.
Originally used to lower fever in febrile patients, they are also used in Sudeck's disease.

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Manual lymph drainage can also be carried out: for this, lymph fluid is drained from the affected tissue, and such a thing Reducing swelling it acts.

Additional compression makes the Lymph drainage accelerates, and the lymphatic congestion within the lymphatic vessels is reduced.

With Decrease in swelling imagine a Reducing pain, and an increase in range of motion.

Occupational therapy

The aim of occupational therapy is to re-introduce the patient into his home and everyday environment, and to bring him back into the world the greatest possible degree of independence, productivity and free time to enable.

Similar to physiotherapy, occupational therapy for the treatment of Sudeck's disease also works with lymphatic drainage to reduce swelling.
Furthermore, through special movement conceptssuch as the use of clay, the muscles are strengthened, and movement sequences are optimized.

A Reintegration of the patient in everyday life, is the primary goal of occupational therapy-supported treatment of Sudeck's disease.
This also includes one as possible efficient use of resources to learn and do this as meaningfully as possible use in everyday life.

Another goal of occupational therapy is in the affected muscle groups to build up strength in a targeted manner. An important part of the therapy is therefore the use of special, dynamic splints that have been proven to promote strength development.

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