Pathophysiology of Complex Regional Pain Syndrome and Treatment: Recent Advancements

AbstractPurpose of ReviewComplex regional pain syndrome (CRPS) is a painful and debilitating disorder involving dysfunction in multiple body systems. This review seeks to evaluate recent data and present treatment options for the practical management of this condition.Recent FindingsThe mechanism by which CRPS develops is multifactorial, affecting both the peripheral and central nervous systems, and nerve changes can be seen at a histologic level. Treatment should be initiated as early as possible, as the chronic disease is less responsive to intervention.SummaryCRPS is a clinical diagnosis; treatment is symptomatic and aimed at addressing the sensory, vasomotor, sudomotor, and trophic changes which occur in the context of severe pain. Management may include therapy, oral or intravenous medication, procedures, or surgery.
Source: Current Emergency and Hospital Medicine Reports - Category: Emergency Medicine Source Type: research

Related Links:

We present a 71-year-old Caucasian non-Hispanic male who presented with chronic left knee pain after undergoing a total knee arthroplasty (TKA) 18  months prior. Following his TKA, he reported doing well in the acute post-operative period but began to develop progressively worsening left knee pain at approximately the third post-operative week. He underwent a successful spinal cord stimulator (SCS) trial and subsequent implantation of two 16- contact Boston Scientific leads with a Boston Scientific Spectra WaveWriterTM SCS system. Upon first post-procedural follow-up, and moreover at his 6-month follow-up, the patient...
Source: Pain and Therapy - Category: Anesthesiology Source Type: research
We report about hirudotherapy in a patient with chronic complex regional pain syndrome (CRPS) in the right hand. CRPS is a multifactorial disease associated with disabling pain as well as sensory and motor deficits. The optimal therapeutic management is based on personalized multimodal treatment approaches; however, hirudotherapy has not been described in the available literature. To date, we have completed five medicinal leech treatments. Altogether, hirudotherapy led to rapid and substantial relief of symptoms, especially with respect to pain intensity ratings and skin temperature asymmetries. In Addition, the patient&rs...
Source: Journal of Integrative Medicine - Category: Complementary Medicine Source Type: research
Authors: Iolascon G, Moretti A Abstract INTRODUCTION: Complex regional pain syndromes (CRPS) are rare painful conditions characterized by considerable variability in possible triggering factors, usually traumatic, and in the clinical scenario. The limited knowledge of the pathophysiological mechanisms has led to countless treatment attempts with multiple conservative and surgical options that act by different mechanisms of action. Areas covered: In this narrative review, the authors discuss key points about CRPS definitions, diagnostic criteria and pitfalls, pathophysiological hypotheses, and treatment strategies w...
Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research
AbstractPurpose of ReviewThe world faces a crisis in pain management. CRPS is a multifaceted painful disorder, which is difficult to treat and resolve. Ozone therapy has unique mechanisms of actions that may directly address the emerging discoveries of factors related to pathogenesis of the disorder and other pain conditions. These include oxygenation, immune modulation, anti-infective properties, and anti-inflammatory properties. This review is to present ozone therapy as a novel approach for pain treatment, including CRPS.Recent FindingsOzone therapy has been found, in basic science studies, to ameliorate many of the mec...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research
Conclusions: Acupuncture therapy seems effective for motor function, pain relief and activities of daily living in stroke patients with mild SHS, when it is used in combination with rehabilitation. The low certainty of evidence downgrades our confidence in making recommendations to clinical practice. Introduction Shoulder-hand syndrome (SHS) is a common condition among people who have had a stroke, with its reported prevalence ranging from 12% to 49% (1, 2). The main symptoms of SHS include pain, hyperalgesia, joint swelling and limitations in range of motion (ROM) (3). Post-stroke SHS is also named type I complex ...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
We examined the expression of TRPV1 in peripheral tissue and DRG neurons of CPIP model rats and we studied whether CPIP model could induce peripheral sensitization of TRPV1 channel and enhance DRG neuron excitability. Then we examined the therapeutic effects of locally applied TRPV1 specific antagonist AMG9810 on pain responses of CPIP model rats. Lastly, we explored the effects of AMG9810 on DRG neuron hyperexcitability and spinal glial activation induced by CPIP. Our results demonstrate that TRPV1 plays an important role in mediating the behavioral hypersensitivity of CPIP model rats via promoting peripheral nociceptor a...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
r H Abstract OBJECTIVE: Repair of the lateral ligament complex of the ankle joint; identification and treatment of intra-articular pathologies. INDICATIONS: Symptomatic chronic lateral ankle instability. Treatment of osteochondral lesions associated with lateral ankle instability. CONTRAINDICATIONS: Osteoarthritis of the ankle joint, risk factors such as peripheral occlusive disease, diabetic foot syndrome, complex regional pain syndrome. SURGICAL TECHNIQUE: Diagnostic arthroscopy of the ankle joint utilizing anterolateral and -medial portals; identification and treatment of intra-articular patholog...
Source: Operative Orthopadie und Traumatologie - Category: Orthopaedics Authors: Tags: Oper Orthop Traumatol Source Type: research
SPR Therapeutics has raised $8 million of a $20 million Series C round of funding that began Jan. 19, according to an SEC filing. The Cleveland-based company’s Sprint peripheral nerve stimulation (PNS) system is FDA-cleared for both chronic and acute pain, including post-operative and post-traumatic pain. The product was launched in November 2018 for treating complex regional pain syndrome, a chronic pain condition affecting the limbs that can be caused by trauma, injury or surgery. The company also recently announced that it has named Peter Staats, M.D., as its chief medical advisor. Staats brings nearly three ...
Source: Mass Device - Category: Medical Devices Authors: Tags: Bioelectronic Medicine Blog Business/Financial News Funding Roundup Neuromodulation/Neurostimulation News Well Pain Management SPR Therapeutics Source Type: news
CONCLUSIONS: Laterality judgment impairment was shown in CPRS1, upper limb pain, hand and wrist pain, carpal-tunnel syndrome, facial pain, knee osteoarthritis, and leg pain. No conclusions could be drawn in low back pain, due to the low-quality evidence and differing results. There was no impairment in whiplash-associated disorders and nonspecific cervical pain showed conflicting evidence. PMID: 30686110 [PubMed - as supplied by publisher]
Source: Physiotherapy Theory and Practice - Category: Physiotherapy Authors: Tags: Physiother Theory Pract Source Type: research
ConclusionsA single S1 DRG electrode placement in patients diagnosed with CRPS of the foot and who had previous back surgery is therapeutically effective and can minimize the risk of dural trauma and CSF leak.
Source: Neuromodulation: Technology at the Neural Interface - Category: Biotechnology Authors: Tags: Case Series Source Type: research
More News: Chronic Pain | Complex Regional Pain Syndrome | Emergency Medicine | Hospitals | Pain | Pain Management