Summary
Reflex sympathetic dystrophy syndrome is a difficult condition to treat. Many modalities have been proposed, all of them being clinically effective but whose efficacy is often difficult to assess, and has not been properly compared. A regimen of physical therapy (pressure therapy, antalgic electrotherapy and exercise therapy) with or without calcitonin was investigated in 24 patients randomly assigned to 2 groups, one given physical therapy alone (Group I) and the other physical therapy plus salmon calcitonin 100 MRC units daily for 3 weeks (Group II). Efficacy assessment was based on clinical (pain, oedema and movement in the affected parts), biochemical (blood and urinary phosphorus and calcium levels, plasma 25-OH-D, plasma parathyroid hormone (PTH), creatinin, alkaline phosphatases and urinary hydroxyproline) and scintigraphic parameters, as well as on the patient's ability to resume working. There was significant improvement in pain in the Group II patients after one week of treatment. As a result the authors advocate the use of calcitonin in addition to physical therapy in reflex sympathetic dystrophy syndrome — and even of calcitonin alone where physical therapy is not possible.
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Hunter, J. Oeuvres complètes. Vol. I. Tortin-Masson. Paris 1864.
Mitchell, S.W., Morehouse, G.R., Keen, W.W. Gunshot wounds and other injuries of nerves. Lippincott. Philadelphia 1864.
Leriche, R. Les réflexes d'axone et les traumatismes périphériques. Importance de leur connaissance et la chirurgie d'accident. Rev Chir 1924, 62, 579–589.
Takats, G. Sympathetic reflex dystrophy. Med Clin North Am 1965, 49, 117–129.
Lorente De No, R. Analysis of the activity of the chains of the internuncial neurons. J Neurophysiology 1938, 1, 207–244.
Ravault, P.P. Le rhumatisme neurotrophique du membre supérieur. Rev Rhum 1951, 18, 74–82.
Gobelet, C. Algoneurodystrophie. Sandorama 1984, I, 28–34.
Bruxelle, J., Menkes, J.C. Traitement de l'algodystrophie par bloc régional intraveineux à la guanéthidine. Rev Rhum 1982, 49, 867–869.
Jacquemoud, G., Chamay, A. Traitement de l'algodystrophie de la main par bloc régional intraveineux à la guanéthidine. Ann Chir Main 1982, 1, 57–64.
Hannington-Kiff, J.G. Relief of Sudeck's atrophy by regional intravenous guanethidine. Lancet 1977, 1132–1133.
May, V., Glowinsky, J. Algoneurodystrophie: Traitement par les béta-bloquants. Nouv Presse Med 1979, 13, 1094.
Glick, E.N. Reflex dystrophy: results of treatment by corticosteroid. Rheumatol Rehabil 1973, 12, 84–88.
Cohen, A., Goldman, J., Daniels, R., Kanenson, W. Treatment of shoulder hand syndrome by griseofulvin. Jama 1960, 173, 542–543.
Stenger, E., Guse, U. Sudecksche Syndrom und Bindegewebsmassage. Aerztl Wochenschr 1950, 5, 573–577.
Dilsen, G. The therapeutic effect of diadynamic current applied over stellate ganglion on 65 cases of shoulder hand syndrome (Abstract 439) IX European Congress of Rheumatology, Wiesbaden 1979.
Wynn-Parry, C.B. The 1981 Philip Nichols Memorial Lecture. Int Rehabil Med 1982, 59–65.
Doury, P., Meunier, P., Roy-Camiller, Seguy, B., Massias, P.: In: Algodystrophy. Springer Verlag. Berlin, Heidelberg, New-York, 1981, 123.
Gobelet, C., Burckhardt, P., Gerster, J.C., Bischof-Delaloye, A. Human calcitonin in the treatment of reflex sympathetic dystrophy syndrome. “R” 1984, 72, 173–178.
Doury, P., Dirrheimer, J., Pattin, S. In: Algodystrophy. Springer Verlag Berlin, Heidelberg, New-York, 1981, 35.
Gennari, C., Francini, G., Gonnelli, S. Nami, R. Bone pain, endorphins and calcitonins. Abstract. First international workshop. The effects of calcitonins in man. Florence April 2–3, 1982.
Arlet, J., Ficat, P., Durroux, R., Theallier, J.P., Mazieres, B., Bouteillier, G. Histopathologie des lésions osseuses dans 9 cas d'algodystrophie de la hanche. Rev Rhum 1978, 45, 691–698.
Tilden, R.L., Jackson, J., Emmeking, W.F., Deland, F.H., Mc Vey, J.T. 99 Tc polyphosphates histological localisation in human femur by autoradiography. J Nucl Med 1979, 14, 576–578.
Lagier, R., Van Linthoudt, D. Dystrophie de Sudeck de l'arrièrepied. Confrontation anatomoradiologique. Ann Radiol (Paris) 1975, 21, 539–544.
Südeck, P. Die kollateralen Entzündungsreaktionen an den Gliedmassen (sog. akute Knochenatrophie). Arch Klin Chir 1938, 191, 710–753.
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Gobelet, C., Meier, J.L., Schaffner, W. et al. Calcitonin and reflex sympathetic dystrophy syndrome. Clin Rheumatol 5, 382–388 (1986). https://doi.org/10.1007/BF02054258
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DOI: https://doi.org/10.1007/BF02054258