Short-Term Teriparatide for Bone Marrow Edema Secondary to Complex Regional Pain Syndrome: Case Reports on Efficacy After Two Years of Follow-Up

Abstract

Bone marrow edema secondary to chronic pain syndrome after knee trauma is a disabling condition that presents with localized pain, allodynia, edema, decreased range of motion and osteopenia. The management includes a variety of medications and rehabilitation. The treatment of refractory diseases is challenging for most physicians. We present two cases of refractory bone edema secondary to complex regional pain syndrome that were successfully treated with a short-term regimen of teriparatide (TPT), a biosynthetic analogue (PTH 1-34) of the human parathormone. The rapid and sustained pain reduction with recovery of knee function for two years following administration of TPT demonstrated its potential for the treatment of bone edema due to complex regional pain syndrome.

Complex Regional Pain Syndrome Following Arterial Thromboembolism: A Rare Case Report

“…As medical treatment, NSAIDs, corticosteroids, bisphosphonates, calcitonin, vitamin C, opioids, free radical scavengers, anticonvulsants such as gabepentin and pregabalin, sympatholytic drugs are recommended. [13][14][15] In cases where pain does not decrease despite all these applications, various invasive methods can be applied such as sympathetic blockage, surgical sympathectomy, spinal cord stimulation, intrathecal baclofen and even amputation. 1,2 As a result, it should be taken into consideration by the physicians that complaints such as pain, edema, and loss of function occurring in the arteries feeding the extremities may occur due to thrombus, as well as they may occur due to CRPS.…”

Reviewing Bone Marrow Edema in Athletes: A Difficult Diagnostic and Clinical Approach

“…According to the authors, these effects may be due to the anabolic capacity of the drug, which is able to affect the cellular pathways of bone metabolism. They suggest a short-term period administration [32].…”