It is a pain syndrome that develops in the joints especially after nerve injuries. Other names include Sudeck's atrophy, Sudeck's dystrophy, algodystrophy, shoulder-hand syndrome, and reflex sympathetic dystrophy.
The major features are (1) pain; (2) dystrophy in involved skin, tissue, muscle, and bone; and (3) abnormal sweating and blood flow regulation in the affected area. Sometimes there is also hypertrichosis and ridging of nails. Weeks or months after myocardial infarction, this syndrome may develop in the left arm and hand ("shoulder-hand syndrome" or "Dressler's syndrome") and mimic the pain of angina pectoris.
After years of skepticism, most investigators now acknowledge the key role of the sympathetic nervous system in mediating causalgia. Destruction of the relevant sympathetic nerves often completely eliminates the pain. There is recent experimental evidence that blockade of a2-adrenoreceptors may also be helpful.
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