calcitonin and Reflex-Sympathetic-Dystrophy

Reflex sympathetic dystrophy syndrome is a peculiar rheumatological pathology whose diagnosis at times is evident, but other times it is complex. This difficulty compels us to have a good knowledge of the syndrome and to take it into account when faced with any rheumatological differential diagnostic. In this work we revise the major aspects of diagnostic.

Topics: Adolescent; Adrenal Cortex Hormones; Adult; Aged; Analgesics; Anti-Inflammatory Agents, Non-Steroidal; Antifungal Agents; Calcitonin; Child; Diagnosis, Differential; Griseofulvin; Humans; Middle Aged; Prognosis; Reflex Sympathetic Dystrophy; Time Factors

The aim of the study was to assess the efficacy of salmon calcitonin, which was suggested as effective in the treatment of complex regional pain syndrome type 1 (CRPS 1). Patients who had suffered trauma to their upper extremities and developed CRPS 1 were included into this randomised, controlled single-blind study. The diagnosis was made according to the clinical examination and scintigraphy. The evaluation parameters were: pain [visual analogue scale (VAS)], the angle of dorsiflexion (DF) and palmar flexion (PF) of the wrist, distance between the fingertip and distal palmar crease (FT-DPC), allodynia, hyperalgesia and trophic changes. One group received paracetamol 1500 m/day and the other group salmon calcitonin 200 IU/day for 2 months. All of the patients participated in a physical therapy and exercise programme. A total of 35 patients were divided into two groups, who were found to be similar for age, body mass index, period of trauma, period of rest in a plaster splint or bandage, the duration of symptoms, VAS, DF and PF angle, FT-DPC, presence of allodynia, hyperalgesia and trophic changes (p>0.05). The control examination showed similar results for allodynia, hyperalgesia and trophic changes, whereas remarkable improvement was observed in the rest of the parameters within groups. On the other hand, between the two groups there was no significant difference in any of the parameters (p>0.05) This randomised, single-blind study showed that all of the patients with acute CRPS 1 in their upper extremities after trauma, who were treated with either paracetamol or calcitonin along with physical therapy, recovered in all parameters significantly, but without any difference between groups. We can conclude that calcitonin does not make any favourable contribution in the treatment of patients with acute CRPS 1; physical therapy combined with only a simple analgesic is an efficient means of therapy.

Topics: Acetaminophen; Analgesics, Non-Narcotic; Calcitonin; Female; Humans; Hyperalgesia; Male; Middle Aged; Pain Measurement; Physical Therapy Modalities; Reflex Sympathetic Dystrophy

Reflex sympathetic dystrophy syndrome (RSDS), or algodystrophy, is a poorly understood, painful syndrome that consists of multiple symptoms, including vasomotor instability, swelling, and chronic pain involving an extremity. Although RSDS following herpes zoster is classically recognized, only a few well-documented cases of this complication have been reported to date. We present the case of a 63-year-old white woman with characteristic signs and symptoms of RSDS in the left upper limb that appeared 3 weeks after she had a typical herpes zona involving the left C5-C6 dermatomes. Early diagnosis and treatment with physiotherapy, intranasal salmon calcitonin, and oral calcium achieved a progressive improvement of the disease, which healed without sequelae in a brief time.

Topics: Administration, Intranasal; Analgesics; Arm; Calcitonin; Calcium; Female; Herpes Zoster; Humans; Middle Aged; Physical Therapy Specialty; Reflex Sympathetic Dystrophy

23 patients with algodystrophy, 28 up to 82 years of age, were treated with calcitonin during the period 1978-1988 and the effect of the treatment is discussed. The treatment was carried out with the drug Myacalcic "Sandoz" in a daily dose of 100 IU, administered intramuscularly every day in the course of 10 days. The following clinical parameters were followed up: pain, swelling, functional capacity, skin (dystrophic) changes. The patients are classified in 2 groups in relation to the results: I. group--acute stage and II. group--chronic stage of the disease. The pain was favourably influenced in both groups by the Myacalcic treatment. In the acute stage the swelling was favourably influenced in 81% of the patients, the skin changes in 89%, the functional capacity was improved 1.64 times. In the chronic stage the swelling was reduced in 25% of the patients, there was no effect on the dystrophic changes and the functional capacity decreased in spite of the treatment.

Topics: Adult; Aged; Aged, 80 and over; Calcitonin; Chronic Disease; Drug Evaluation; Female; Humans; Male; Middle Aged; Reflex Sympathetic Dystrophy

Topics: Aerosols; Calcitonin; Female; Humans; Injections, Intramuscular; Male; Reflex Sympathetic Dystrophy