Interventions for treating pain and disability in adults with complex regional pain syndrome- an overview of systematic reviews

Abstract

Interventions for treating pain and disability in adults with complex regional pain syndrome-an overview of systematic reviews.

Neuromodulation in Treating Complex Regional Pain Syndrome: A Critical Review of the Evidence

“…Furthermore, the clinical effects do not appear to be significant to change either syndrome development or quality of life. Even multiple-session of rTMS did not consistently reveal to be effective [21,31,32]. In agreement to this, it has been reported that CRPS pain improvement only occurs during rTMS sessions [31,32].…”

“…Furthermore, controlled trials have never succeeded in proving the effectiveness of either guanethidine intravenous infusion or surgical sympathectomy, which sometimes are associated to high rates of adverse events [21].…”

“…The evidences of positive effects on CRPS pain Pleger [28][29][30] and Picarelli [31,32] favoring rTMS at high frequency over the motor cortex were classified as strong by Cossins [29], though O'Connell [21,22] has rated them as very low quality of evidence (downgraded for the small sample size, short duration of follow up, small and short-term analgesic effect). Furthermore, the clinical effects do not appear to be significant to change either syndrome development or quality of life.…”

“…According to this, a Cochrane systematic review and three others papers in the medical literature have concluded for limited evidence in quality and quantity [21,29,43,44]. Although the risks of death or critical complications with SCS were uncommon and low, undesirable occurrences were frequent and costs were considered high.…”

“…Although many drugs are very helpful (especially if associated to a rehabilitation program), none of them have promoted significant alterations in syndrome course [3,6,10,[21][22][23]]. …”