Complex Regional Pain Syndrome: A Comprehensive Review

Taylor, Samantha-Su; Noor, Nazir; Urits, Ivan; Paladini, Antonella; Sadhu, Monica Sri; Gibb, Clay; Carlson, Tyler; Myrcik, Dariusz; Varrassi, Giustino; Viswanath, Omar

doi:10.1007/s40122-021-00279-4

Cited by 126 publications

(149 citation statements)

References 115 publications

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“…Increased expression of -1 adrenergic receptors on keratinocytes and nociceptors was shown to explain the autonomic imbalance of CRPS in later research. Sympathetic activity normally leads in the production of catecholamines like norepinephrine, which bind to -1 adrenergic receptors and cause vasoconstriction.Patients with CRPS, on the other hand, had lower norepinephrine levels in the afflicted leg but higher total systemic catecholamine expression [19][20][21].…”

Section: Autonomic Nervous System [19-22]mentioning

confidence: 96%

“…As a result, peripheral -1 adrenergic receptors become more sensitive and activated. This causes vasodilation and increased blood flow to the limb with CRPS, resulting in warmth and erythema.Similarly, during the chronic cold phase of CRPS, prolonged release of proinflammatory cytokines, such as endothelin-1, causes excessive sympathetic nervous system outflow, which leads to increased norepinephrine levels and decreased -1 adrenergic receptor expression, resulting in vasoconstriction and the development of a cold, blue, clammy limb [19][20][21].…”

Section: Autonomic Nervous System [19-22]mentioning

confidence: 99%

“…Patients who had hyperalgesia after receiving phenylephrine injections had more cutaneous -1adrenergic receptors. Patients with CRPS II, as well as those with acute CRPS, have higher levels of -1 adrenergic receptor expression than those with chronic CRPS [19,22].…”

Section: Autonomic Nervous System [19-22]mentioning

confidence: 99%

“…Vitamin C, on the other hand, is the only antioxidant treatment that is currently supported by data and is widely administered perioperatively to prevent CRPS after extremities surgery. The most recent metaanalysis, which included three RCTs with a total of 875 participants, found that patients taking daily 500 mg vitamin C supplements for 50 days had a significantly lower 1-year incidence of CRPS following wrist fracture [19,[31][32][33][34].…”

Section: Antioxidants [1931-34]mentioning

confidence: 99%

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Overview on Complex Regional Pain Syndrome: A Review

Alabdaly

Alramadhan

Almutairi

et al. 2021

JPRI

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Complex regional pain syndrome (CRPS) is a neuropathic pain disease characterized by the presence of allodynia, hyperalgesia, sudomotor and vasomotor abnormalities, and trophic alterations. CRPS can be caused by a variety of degrees or types of tissue damage, but it has also been reported in the absence of injury or after lengthy periods of immobility. A fracture is the most prevalent injury linked to the development of CRPS. CRPS is thought to be caused by a complex process involving both the peripheral and central nerve systems, according to a recent acceptance. Patients with CRPS are said to have all of the symptoms of inflammation, including heat, discomfort, redness, and swelling. CRPS symptoms have been greatly reduced by corticosteroids in several clinical studies. The diagnosis of CRPS is mostly dependent on a patient's medical history and clinical examination, which includes a variety of tests that can help rule out other diseases. Given the syndrome's complexity, it's doubtful that focusing on a single mechanism will be successful. Combination therapy, like with other chronic conditions, may be the future of CRPS treatment. In this review we will be looking at disease definition, pathophysiology, and treatment.

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Section: Autonomic Nervous System [19-22]mentioning

confidence: 96%

Section: Autonomic Nervous System [19-22]mentioning

confidence: 99%

Section: Autonomic Nervous System [19-22]mentioning

confidence: 99%

Section: Antioxidants [1931-34]mentioning

confidence: 99%

See 2 more Smart Citations

Overview on Complex Regional Pain Syndrome: A Review

Alabdaly

Alramadhan

Almutairi

et al. 2021

JPRI

View full text Add to dashboard Cite

show abstract

“…The patient positions a mirror such that when the patient moves their healthy limb, their brain perceives the mirror reflection as the limb that is affected by chronic pain (except healthy looking and moving without pain instead of the stump that remains hidden from the patients view during mirror therapy). Research shows that for patients with phantom limb pain and some other chronic pain syndromes (e.g., Complex Regional Pain Syndrome, or CRPS), this type of therapy (mirror therapy) helps improve function and reduce pain (Smart et al, 2016;Méndez-Rebolledo et al, 2017;Taylor et al, 2021).…”

Section: The Innovative Use Of Mirror Therapy For Treating Chronic Painmentioning

confidence: 99%

Immersive Virtual Reality: A Safe, Scalable, Non-opioid Analgesic for Military and Veteran Patients

Peterson¹,

Hitching

Howard

et al. 2021

Front. Virtual Real.

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In Iraq and Afghanistan over 75% of the combat casualties suffered by U.S. troops have involved explosive devices. Improvements in body armor and advances in military medicine have significantly reduced the number of combat-related fatalities, but have greatly increased the number of U.S. active component personnel suffering painful trauma injuries. Unfortunately, so far, advances in pharmacologic analgesia pain medications have not kept pace with advances in survivability. For many active component personnel and Veterans, pain is a top health complaint from patients. The opioid epidemic has increased the urgency of developing powerful non-pharmacologic approaches for the management of pain. Immersive VR is proving to be a powerful non-opioid pain management technique for acute pain. However, the cost and usability limitations of pre-2016 VR clinical products resulted in limited treatment adoption rates for clinical use. In recent years, VR technology has become increasingly immersive, portable, and miniaturized, requiring minimal technical expertise to operate, and low-cost, factors that are likely contributing to the recent increase in the clinical use of VR analgesia. VR is greatly benefitting from a growing string of major technological breakthroughs and VR treatment improvements that will likely continue to increase the effectiveness and suitability of VR analgesia for military and VA patients. Regarding acute pain, we propose that the next revision to the current Tactical Combat Casualty Care guidelines consider including VR as an effective and hemodynamically safe approach to the current management of acute trauma pain in military personnel during medical procedures. With recent miniaturization and ruggedization, VR can potentially be used closer to the battlefield in the future. Beyond distraction, innovative VR therapy techniques designed to help reduce chronic pain are discussed. Recent breakthroughs in the mass production of inexpensive, highly immersive lightweight stand alone VR systems and augmented reality systems increase the potential for widespread dissemination of VR analgesia for acute and potentially for chronic pain. For example, the U.S. military recently purchased 22 billion dollar’s worth of Microsoft Hololens mixed reality systems (e.g., for training). Expanded research and development of VR analgesia customized for the unique needs of military and VA patients is recommended.

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Skin Conditions and Movement Disorders: Hiding in Plain Sight

Kulcsarová

Baloghová

Necpál³

et al. 2022

Movement Disord Clin Pract

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Skin manifestations are well-recognized non-motor symptoms of Parkinson's disease (PD) and other hypokinetic and hyperkinetic movement disorders. Skin conditions are usually well visible during routine clinical examination and their recognition may play a major role in diagnostic work-up. In this educational review we:(1) briefly outline skin conditions related to Parkinson's disease, including therapy-related skin complications and their management; (2) discuss the role of skin biopsies in early diagnosis of PD and differential diagnosis of parkinsonian syndromes; and focus more on areas which have not been reviewed in the literature before, including (3) skin conditions related to atypical parkinsonism, and (4) skin conditions related to hyperkinetic movement disorders. In case of rare hyperkinetic movement disorders, specific dermatological manifestations, like presence of angiokeratomas, telangiectasias, Mongolian spots, lipomas, ichthyosis, progeroid skin changes and others may point to a very specific group of disorders and help guide further investigations.

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Complex Regional Pain Syndrome: A Comprehensive Review

Cited by 126 publications

References 115 publications

Overview on Complex Regional Pain Syndrome: A Review

Overview on Complex Regional Pain Syndrome: A Review

Immersive Virtual Reality: A Safe, Scalable, Non-opioid Analgesic for Military and Veteran Patients

Skin Conditions and Movement Disorders: Hiding in Plain Sight

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