Sudeck’s atrophy, CRPS

Complex regional pain syndrome (CRPS) belongs to the category of neurological-orthopaedic-traumatological disorders.

Treatment is often prolonged and can be frustrating for both patient and therapist. Prognosis is best when the disorder is identified and treated early. Chronically severe cases are rare – 2 per cent of all cases.

The pleasant standing and walking experience on the soft, elastic surface that kybun provides eases the pain. At the same time, it improves circulation, which supports healing. It also strengthens the musculature of your feet and legs, and stabilizes the joints.

Definition

The disorder is characterised by dystrophy and atrophy developing over a long period in parts of limbs as a result of external influences (such as traumas, operations or inflammation). Symptoms include circulation problems, oedemas, skin alterations, pain and ultimately functional impairment.

Sudeck’s atrophy is particularly common on the hands, lower arms, feet and lower legs, with the upper extremities about twice as likely to be affected. The disorder often develops following radial fractures. Women are particularly susceptible to this disorder.

Causes

One possible cause being discussed that has not yet been satisfactorily researched is an inflammatory neuronal reaction, peripheral as well as central, in combination with a cortical reorganisation.

The pathogenesis of CRPS is still not fully understood. It is suspected that the healing process in the affected tissue is disrupted. It is worth noting that the development and severity of CRPS does not depend on the severity of the initial injury.

The following development model is currently being discussed: An inflammation reaction arises in which inflammation mediators (the substances P, CGrP) are secreted and cannot be sufficiently degraded, causing the neurogenic inflammatory reactions to be prolonged.

The role of psychological factors in the development of CRPS has been a controversial issue for some time, but the existence of a so-called ‘CRPS personality’ has been largely dismissed. However, multiple studies have revealed that the onset of the disorder is often preceded by an accumulation of stressful experiences and higher rates of post-traumatic stress disorders.

Long-term consequences

The symptoms are non-specific at first, meaning that diagnosis is sometimes delayed. The course of the disease also varies greatly from individual to individual, with everything from spontaneous total remission to progression with a substantial reduction in quality of life.

The prognosis tends generally to be unfavourable because the symptoms can only be correctly recognised at a relatively late stage.

Conventional therapy

An interdisciplinary therapeutic approach should be taken, involving both opioids and non-opioid analgesics for pain therapy. Other treatment options include the prescription of bone-regeneration medications, ergotherapy, physiotherapy, medications with local antiphlogistic effects and, in some cases, injecting local anaesthetics into the vegetative nervous system (sympathetic blocks).

The kybun principle of operation – being proactive

The kyBoot can have a positive effect on Sudeck’s atrophy in the following ways:

• The soft, elastic kyBoot sole absorbs the impact of hard surfaces. The gentle walking experience reduces foot or leg pain, allowing you to walk longer distances.
• Reducing leg stimuli also reduces inflammation/irritation, which in turn reduces pain
• Proprioception/stabilization training for the foot, knee or leg musculature provides more foot stability, reduces pain and preserves the musculature.
• The gentle movement while walking in the kyBoot/on the kyBounder improves circulation, supports healing and counteracts autonomic dysfunctions such as redness, sweating, swelling ...
• The gentle movement while walking in the kyBoot/on the kyBounder stimulates the lymph system and promotes return flow, reducing swelling in the foot/knee.

Initial reactions

Specific initial reactions with Sudeck’s atrophy (CRPS):

At first, users may experience an exacerbation of symptoms (more pain, increased swelling ...) if they train too long or too intensely in the kyBoot/on the kyBounder. Less is more in the beginning! The kyBoot/kyBounder is an intensive training device and the body usually requires several weeks or months to become accustomed to the new, natural walking experience with kybun. You can find out more in the ‘Application tips’.

Click here for the general initial reactions experienced by kyBounder and kyBoot beginners: Initial reactions

kybun exercises

For information about the special kyBoot exercises or the basic kyBounder exercises , please click here: kybun exercises

Application tips

• The more acute the phase of the disorder is, the more cautious you should be when increasing the duration of time you wear the kyBoot.
• We advise you to perform the kybun exercises regularly every now and again. They generally loosen your musculature and straighten the body. Choose the exercises that are good for you and listen to your body when deciding on the dosage.
• If you get very fatigued in spite of the kybun exercises, or if you feel pain or in case of lateral/medial rolling of the ankle joint on the kybun sole, we advise you to take a short kyBoot/kyBounder break until the symptoms go away.
• If you feel unstable wearing the kyBoot or are looking for an additional training device to use at home, the kyBounder is the ideal alternative. You can strengthen your foot, leg and back musculature at home with the soft, elastic springy mat. You can hold on to a fixed object if you feel unstable. The kyBounder is also available in a choice of different thicknesses (the thicker, the more intensive the training). Ask your local kybun dealer for advice.
• Be sure to maintain an upright posture, avoid taking excessively long stepsandkeep your gaze forward(do not look at the floor). You should walk straight on the kyBoot sole and correct any lateral/medial rolling of the ankle joint! You can find out more under ‘Lateral/medial rolling’.
• There may occasionally be an increase in symptoms at first (more pain, for example), but this should steadily decrease after a few days. If pain or an increase in other symptoms such as swelling continues, contact your local kybun dealer and arrange a consultation.