Foot algodystrophy
Algodystrophy, or complex regional pain syndrome, manifests as intense and persistent pain in the foot, often after trauma or surgery. The Foot Clinic offers you specialized care to better understand and treat this condition.
On this page, you will discover its definition, symptoms, diagnosis, causes, as well as therapeutic options and the personalized follow-up offered by our team of experts.
What is foot algodystrophy?
Algodystrophy, also known as algoneurodystrophy or CRPS, refers to a disproportionate pain reaction following an injury or trauma. It typically progresses through two distinct phases.
The so-called "hot" phase involves pain, redness, and inflammation, while the "cold" phase is characterized by a decrease in skin temperature, joint stiffness, and various trophic changes. These symptoms indicate a dysfunction of the peripheral and central nervous system, and can be triggered following surgery or an accident.
Symptoms of foot algodystrophy
The main symptoms are pain, vasomotor disorders, and neurological disorders.
- Pain is very severe, even too severe for the clinical context. It is barely or poorly relieved by standard painkillers.
- Vasomotor disorders are of two kinds depending on the phase of algodystrophy. There are two phases that generally follow one another: the hot phase and the cold phase.
In the hot phase, there is an increase in the temperature of the foot with algodystrophy, with increased vessel permeability due to vasoplegia, and an overall edema of the foot with the skin appearing rather red.
In the cold phase, the foot temperature decreases, and the foot feels colder. The skin appears bluish with a cyanotic aspect.
There are also neurological manifestations. Compression of the nerves by edematous tissues can lead to tingling sensations called paresthesias, pain when the skin is touched called hyperesthesias, and unusual sensations called dysesthesias. Patients also have the impression of having their foot in a vice.
What are the causes of foot algodystrophy?
Algodystrophy can complicate a foot fracture or a sprain of the foot.
- In the case of stress fractures of the foot, the progression can be long and painful with a delayed diagnosis, because the stress fracture may initially go unnoticed.
On initial X-rays, the fracture line may be invisible, and it is only on images taken after the 3rd week that the bone callus may appear. - Sprains of the foot, especially of the hindfoot and midfoot, are more difficult to diagnose than ankle sprains. There is often a delay in diagnosis and therefore in treatment, particularly of the pain, which can potentially be responsible for algodystrophy.
Pain management is crucial in trying to prevent progression to algodystrophy.
Algodystrophy after surgical intervention
- Preventive treatment consists of giving a vitamin C supplement at a dose of 500 mg per day for 2 to 3 months.
- Pain management during and after the operation is very important.
- Postoperative physiotherapy should follow the rule of no pain.
- Surgical treatment failures can lead to algodystrophy. Every effort must be made to resolve all surgical issues with the foot in a single procedure.
- It is necessary to use minimally invasive,percutaneous or even arthroscopic techniques, which limit tissue dissection and thus the severity of postoperative pain.
Algodystrophy after hallux valgus surgery is a potential problem in particular.
What are the treatments for foot algodystrophy?
It should be offered in a sustained manner, as the progression of algodystrophy is lengthy.
Rehabilitation helps maintain the range of motion in the foot joints to limit stiffness and preserve muscle trophism.
Balneotherapy can improve the symptoms of algodystrophy, with Scottish baths alternating between hot and cold.
Surgical treatment is rare in cases of algodystrophy, as there is a risk of making it worse. However, some untreated lesions can cause and maintain algodystrophy; in such cases, a surgical intervention may be suggested to repair them.
Recovery is long and can last 12 to 18 months. Psychological support is necessary throughout the course of the condition.
It is possible to recreate the sensation of Scottish baths by using the shower at home and alternating hot and cold water on the foot.
Why Choose The Foot Clinic
At La Clinique du Pied, the expertise of our team, led by Doctor Schramm, is based on comprehensive management of foot and ankle conditions. We offer each patient a personalized care pathway, focusing on minimally invasive techniques such as arthroscopy and percutaneous procedures.
Regular and reassuring follow-up allows us to adapt rehabilitation as well as medication treatments, in order to ensure optimal and continuous care.
FAQ
Yes, you should walk with algodystrophy to maintain joint mobility and muscle trophicity.
During highly inflammatory phases, bearing weight may be impossible, but you should persevere.
Foot algodystrophy can last up to 12 to 18 months.
Pain management includes:
- Traditional painkillers
- Painkillers effective on neuropathic pain
- Rehabilitation sessions with balneotherapy
- Alternating hot and cold