Reflex sympathetic dystrophy, Sudeck’s atrophy or complex regional pain is a very painful chronic musculoskeletal condition that affects the upper limb with special intensity. It produces joint stiffness, with little mobility, burning sensation together with cutaneous hypersensitivity, strong inflammation (due to the abnormal accumulation of fluid in the tissues), redness, sweating, etc.

It can occur at any age, but it is more frequent in women between 40 and 60 years old, although this diagnosis is increasingly raised among young people. For its control, powerful analgesic and neuromodulatory drugs that reduce pain are used, among the latter some employed in psychiatric disorders, epilepsy, etc. such as anticonvulsants, antidepressants and antipsychotics.

Dr. Piñal does not consider Sudeck’s atrophy a pathology per se, but rather a diagnostic formula that masks an unidentified origin of the patient’s real problems, which appear after an intervention, a fracture or an infectious process, among other precedent pictures.

Thus, more than a century after its description as “acute inflammatory bone atrophy” by the German surgeon Paul Südeck, Dr. Piñal and his surgical unit have already cured dozens of patients with this diagnosis, through a clinical approach that goes through the re-evaluation of the case and, sometimes, also by surgery, which in expert hands produces spectacular results.

It’s a surgical procedure that requires a thorough prior analysis and great experience and technique to rule out, locate and address the source of a problem that has gone unnoticed for other surgeons.