Causalgia is intense burning pain and sensitivity to the slightest vibration or touch, usually in the hand or foot, at a site some distance removed from a wound that has healed. This phenomenon was first described in 1872 by the American neurologist Silas Weir Mitchell. Now this is typically known as Reflex Sympathetic Dystrophy Syndrome or Complex Regional Pain Syndrome.
Symptoms usually involve burning pain prominent in the hand or foot within 24 hours of injury. Almost any sensory stimulation worsens the pain.
Vascular changes include either increased or decreased blood flood due to dilation or constriction of blood vessels.
Other symptoms include dry, scaly skin; still joints; tapering fingers; ridged nails; long, coarse hair or hair loss; and changes in sweating.
- Medical therapy is usually ineffective.
- Sympathetic block, which involves a series of localized anesthetic injections to block certain signals from the sympathetic nervous system, brings lasting relief to 18 percent to 25 percent of patients.
- Surgical sympathectomy, or surgery to block certain nerve signals, brings complete relief to more than 80 percent of patients and relief of sympathetic symptoms to 90 percent. Similar results are found among patients with reflex sympathetic dystrophy.
- Techniques used include anterior thoracic, thoracic endoscopy, percutaneous radiofrequency and supraclavicular.
- The risk of significant complication is approximately 5 percent.
- Risks include collapsed lung, pain in the rib area, spinal cord injury, and Horner’s syndrome. Symptoms of the syndrome include drooping eyelid, contracted pupils, absence of sweating and receding eyeball.