<p>Peripheral Neuropathic Pain and Pain Related to Complex Regional Pain Syndrome with and without Fixed Dystonia – Efficient Therapeutic Approach with Local Anesthetics</p>

Abstract

Peripheral Neuropathic Pain (PNP) as well as the Complex Regional Pain Syndrome (CRPS), also known as "Reflex Sympathetic Dystrophy", or "Sudeck Dystrophy", all of them have a poor prognosis. The numerous therapeutic offers are rarely accompanied by convincing success over a long duration of time. Even worse is the prognosis of a fixed dystonia which may develop in the extremities of PNP or CRPS patients. In literature a few cases are reported in which the often unbearable pain of those patients with or without a disabling dystonia disappeared immediately after the injection of local anesthetics (LAs) into the scars of a preceding trauma. This review evaluates publications concerning the neuropathological characteristics of fixed dystonia in PNP/ CRPS patients and the electrophysiological processes of scar neuromas. The results of these evaluations support the understanding of the therapeutic successes and their immediate results reported above by the injection of LAs into triggering scars. Therapeutic options are discussed.

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

“…Complex Regional Pain Syndrome: Natural History and Presentation The complex regional pain syndrome (CRPS) is characterized by persistent pain, predominantly impacting the limbs [10][11][12]. The condition is categorized into two types, with Type I manifesting when symptoms arise subsequent to a traumatic event [13]. CRPS-1 frequently occurs in cases of upper limb injuries stemming from fractures and surgical procedures, with distal radius fractures (DRFs) being a common cause [14].…”

“…CRPS-1 frequently occurs in cases of upper limb injuries stemming from fractures and surgical procedures, with distal radius fractures (DRFs) being a common cause [14]. Type II, on the other hand, is linked to nerve injuries [13]. A separate source on the complex regional pain syndrome suggests that both types can result from trauma, with the distinction hinging on evident nerve injury, observed exclusively in Type II.…”

“…The Budapest Criteria are used to diagnose clinical CRPS [20]. They were developed in 2003 and have enhanced specificity compared to the old IASP (International Association for the Study of Pain) criteria [13,21]. The CRPS is diagnosed when alternative diseases are eliminated [20].…”