Complex Regional Pain Syndrome: Evidence-Based Advances in Concepts and Treatments

Limerick, Gerard; Christo, Dana K.; Tram, Jennifer; Moheimani, Roya; Manor, John; Chakravarthy, Krishnan; Karri, Jay; Christo, Paul J.

doi:10.1007/s11916-023-01130-5

Cited by 5 publications

(3 citation statements)

References 262 publications

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“…Because the treatment for CRPS may be insufficient with only sympathetic blocks, and it requires a multimodal approach 30 . In addition to sympathetic blocks, pharmacological agents, rehabilitation interventions, pain exposure therapy, neuromodulation, and intrathecal morphine or baclofen pump are being attempted for relieving pain in CRPS, but so far, they only provide uncertain evidence 31 , 32 . Also, Harden, et al pointed out in a recent review that due to CRPS being a rare and complicated multifactorial disease, previous studies clearly demonstrating treatment efficacy are limited 33 .…”

Section: Discussionmentioning

confidence: 99%

Effect duration of lumbar sympathetic ganglion neurolysis in patients with complex regional pain syndrome: a prospective observational study

Choi,

Kim,

Lim

et al. 2024

Sci Rep

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Lumbar sympathetic ganglion neurolysis (LSGN) has been used for long-term pain relief in patients with complex regional pain syndrome (CRPS). However, the actual effect duration of LSGN has not been accurately measured. This prospective observational study measured the effect duration of LSGN in CRPS patients and investigated the relationship between temperature change and pain relief. After performing LSGN, the skin temperatures of both the maximum pain site and the plantar area in the affected and unaffected limbs were measured by infrared thermography, and pain intensity was assessed before and at 2 weeks, 1 month, and 3 months. The median time to return to baseline temperature was calculated using survival analysis. The skin temperature increased significantly at all-time points relative to baseline in both regions (maximum pain site: 1.4 °C ± 1.0 °C, plantar region: 1.28 °C ± 0.8 °C, all P < 0.001). The median time to return to baseline temperature was 12 weeks (95% confidence interval [CI] 7.7–16.3) at the maximum pain site and 12 weeks (95% CI 9.4–14.6) at the plantar area. Pain intensity decreased significantly relative to baseline, at all-time points after LSGN. In conclusion, the median duration of the LSGN is estimated to be 12 weeks.

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Section: Discussionmentioning

confidence: 99%

Effect duration of lumbar sympathetic ganglion neurolysis in patients with complex regional pain syndrome: a prospective observational study

Choi,

Kim,

Lim

et al. 2024

Sci Rep

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“…In a study identifying risk factors for the complex regional pain syndrome (CRPS), an analysis involving 647 cases from the Danish Patient Compensation Association revealed that the female gender, upper limb involvement, and surgical intervention were identified as risk factors [37]. Notably, age was not identified as a risk factor; however, a systematic literature review emphasized that the risk increases after menopause, primarily due to osteoporosis [38,39]. The patient discussed in this report was a post-menopausal woman who underwent surgery on an upper limb after an injury.…”

Section: Discussionmentioning

confidence: 99%

Complex Regional Pain Syndrome after Distal Radius Fracture—Case Report and Mini Literature Review

Świta,

Szymonek,

Talarek

et al. 2024

JCM

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This study explores the impact of the complex regional pain syndrome (CRPS) on the lives and mobility of patients, with a particular focus on its emergence as a late complication of distal radius fractures (DRFs), a common occurrence, especially among an aging population. The absence of a standardized treatment for the CRPS and the challenge of predicting its occurrence make it a complex medical issue. This research aims to shed light on the effects of treating the CRPS through a case study involving a 75-year-old woman with untreated osteoporosis who experienced a Colles fracture after a fall. The initial management involved repositioning and stabilizing the fractured forearm with a plaster cast, followed by an operation using percutaneous pinning via a Kirschner wire. Subsequently, the patient developed CRPS symptoms and was admitted to the rehabilitation department three months post-fracture. The affected forearm exhibited swelling, warmth, pain, and severely limited range of motion. Treatment involved a combination of medications, physiotherapy, and kinesiotherapy. Significantly, the patient experienced notable improvement following these interventions. This study underscores the absence of a definitive standard for CRPS treatment but suggests that proper rehabilitation and pharmaceutical interventions can contribute positively to patient outcomes. The case further highlights the potential association between DRF and CRPS development, emphasizing the need for continued research in this field.

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“…Chronic inflammation may occur in cases of unresolved inflammation, resulting in chronic pain [5]. Unlike nociceptive and inflammatory pain that arises from disease or tissue damage, neuropathic pain can be a disease in itself [6,7]. It is generally chronic and is caused by lesions within the somatosensory system, which bidirectionally communicates with the immune system [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Role of Resolvins in Inflammatory and Neuropathic Pain

Park,

Roh,

Pan

et al. 2023

Pharmaceuticals

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Chronic pain is an unpleasant experience associated with actual or potential tissue damage. Inflammatory pain alerts the body to inflammation and promotes healing; however, unresolved inflammation can lead to chronic pain. Conversely, neuropathic pain, due to somatosensory damage, can be a disease in itself. However, inflammation plays a considerable role in the progression of both types of pain. Resolvins, derived from omega-3 fatty acids, actively suppress pro-inflammatory mediators and aid in the resolution of inflammation. Resolvins alleviate various inflammatory and neuropathic pain models by reducing hypersensitivity and regulating inflammatory cytokines and glial activation in the spinal cord and dorsal root ganglia. Thus, resolvins are a promising alternative for pain management with the potential to reduce the side effects associated with conventional medications. Continued research is crucial to unlock the therapeutic potential of resolvins and integrate them into effective clinical pain management strategies. This review aimed to evaluate the literature surrounding the resolvins in inflammatory and neuropathic pain.

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Complex Regional Pain Syndrome: Evidence-Based Advances in Concepts and Treatments

Cited by 5 publications

References 262 publications

Effect duration of lumbar sympathetic ganglion neurolysis in patients with complex regional pain syndrome: a prospective observational study

Effect duration of lumbar sympathetic ganglion neurolysis in patients with complex regional pain syndrome: a prospective observational study

Complex Regional Pain Syndrome after Distal Radius Fracture—Case Report and Mini Literature Review

Role of Resolvins in Inflammatory and Neuropathic Pain

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