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Complex Regional Pain Syndrome and its Treatment: An Overview


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1 Malla Reddy Institute of Pharmaceutical Sciences, Maisammaguda, Dullapally (Post via Hakimpet), Secunderabad - 500 014, India
     

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Complex regional pain syndrome type I (CRPS type I)--formerly reflex sympathetic dystrophy (RSD)--causes chronic, poorly controllable pain, autonomic, sensorimotor disorders, and serious trophic alterations in the later stages. It develops in the distal extremities mostly after minimal trauma or surgical intervention and rarely spontaneously. The severity of symptoms is disproportionate to the causative event. The latest scientific findings show that the previously called reflex sympathetic dystrophy (RSD), which was supposed to be a result of a hyper-reactive autonomic nervous system, is a very complex syndrome that occurs on different integration levels of the nervous system. The International Association for the Study of Pain (ISAP) introduced the more descriptive term "complex regional pain syndrome" (CRPS) in 1994. Possible role of peripheral inflammatory processes, abnormal sympathetic-afferent coupling and various other novel mechanisms of patho-physiology have led to various medications ,Physical therapy, occupational therapy, and psychotherapy which play an important role in the primary treatment of CRPS as non-invasive procedures.

Keywords

Complex Regional Pain Syndrome, Neuropathic Pain, Reflex Sympathetic Dystrophy, Causalgia Treatment Advances, Peripheral Nervous System.
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  • Medifocus Guidebook on Reflex Sympathetic Dystrophy Updated January 25,2011,171 pages
  • Author: Steven J Parrillo, DO, FACOEP, FACEP; Chief Editor: Robert E O'Connor, MD, MPH.,Complex Regional Pain Syndrome in Emergency Medicine MEDSCAPE Updated: Apr 15, 2011 Copyright © 1994-2011 by WebMD LLC.
  • Daniel B. Hoch, PhD, MD, National Institute of Neurological Disorders and Stroke. Complex regional pain syndrome fact sheet. Updated December 21, 2009. Accessed January 19, 2010
  • Wasner G, Schattschneider J, Baron R. Skin temperature side differences-a diagnostic tool for CRPS? Pain 2002; 98:19-26
  • Wasner G, Schattschneider J, Binder A, Baron R. Complex regional pain syndrome-diagnostic, mechanisms, CNS involvement and therapy. Spinal Cord 2003; 41:61-75.
  • Baron R. Classification and diagnostic tools in complex regional pain syndrome. Newsletter of the IASP Special Interest Group on Neuropathic Pain 2006;7:3-7.
  • Study of Proteins Associated With Complex Regional Pain Syndrome Verified on February 2011 by National Institutes of Health Clinical Center (CC),ClinicalTrials.gov.
  • Coderre TJ, Bennett GJ. Department of Anesthesia, Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, Canada. A hypothesis for the cause of complex regional pain syndrome-type I (reflex sympathetic dystrophy): pain due to deep-tissue microvascular pathology Pain Med. 2010 Aug;11(8):1224-38.terence.coderre@mcgill.ca PMID:20704671[PubMed - indexed for MEDLINE]
  • Jan Dommerholt* Complex regional pain syndromeF1: history,diagnostic criteria and etiology: Journal of Bodywork and Movement Therapies (2004) 8, 167-177
  • Birklein.F, Schmelz.M, Neuropeptide, neurogenic inflammation and complex regional pain syndrome (CRPS). Neurosci. Lett. 2008; 437-199-202.
  • Capelle, Hans-Holger MD; Weigel, Ralf MD; Schmelz, Martin MD; Krauss, Joachim K. MD Neurotrophins in the Cerebrospinal Fluid of Patient Cohorts With Neuropathic Pain, Nociceptive Pain, or Normal Pressure Hydrocephalus Clinical Journal of Pain: October 2009 - Volume 25 - Issue 8 - pp 729- 733
  • Marzec JM, Christie JD, Reddy SP, Jedlicka AE, Vuong H, Lanken PN, Aplenc R, T, Yamamoto M, Cho H-Y, Kleeberger SR. Functional polymorphisms in the transcription factor NRF2 in humans increase the risk of acute lung injury. The FASBE J 2007; 21:2237-2246.
  • Howard S. Smith, MD. 3159The Role of Genomic Oxidative- Reductive Balance as Predictor of Complex Regional Pain Syndrome Development: A Novel Theory Pain Physician 2010; 13:79-90 • ISSN 1533- Free full manuscript: www.painphysicianjournal.com.
  • Koban M, Leis S, Schultze-Mosgau S, Birklein F. Tissue hypoxia in complex regional pain syndrome. Pain. 2003;104:149-157
  • Birklein F, Weber M, Neundorfer B. Increased skin lactate in complex regional pain syndrome: evidence for tissue hypoxia? Neurology. 2000;55:1213-1215
  • Heerschap A, Den Hollander JA, Reynen H, Goris RJ. Metabolic changes in reflex sympathetic dystrophy: a 31P NMR spectroscopy study. Muscle Nerve. 1993;16:367-373.
  • Van Der Laan L, Ter Laak HJ, Gabreels-Festen A, Gabreels F, Goris RJ. Complex regional pain syndrome type I (RSD): pathology of skeletal muscle and peripheral nerve. Neurology. 1998;51:20-25. 29.
  • Birklein F, Weber M, Ernst M, Riedl B, Neundorfer B, Handwerker HO. Experimental tissue acidosis leads to increased pain in complex regional pain syndrome (CRPS). Pain. 2000;87:227-234.
  • Tan EC, De Keijzer MH, Goris RJ. Capillary blood gas analysis in complex regional pain syndrome: a pilot study. Ann Clin Biochem. 2003;40:569-571.
  • Marissa De Mos MD, MSc, Miriam C. J. M. Sturkenboom PharmD, PhD, Frank J. P. M. Huygen MD, PhD .Pain Practice Volume 9, Issue 2, pages 86-99, March/April 2009 Complex Regional Pain Syndrome
  • . Ludwig J, Gorodetskaya N, Schattschneider J, Janig W, Baron R. Behavioral and sensory changes after direct ischemiareperfusion injury in rats. Eur J Pain. 2007;11:677-684.
  • .Perez RS, Zuurmond WW, Bezemer PD, et al. The treatment of complex regional pain syndrome type I with free radical scavengers: a randomized controlled study. Pain. 2003;102:297-307.
  • . Hartrick CT. Increased production of nitric oxide stimulated by interferon-gamma from peripheral blood monocytes in patients with complex regional pain syndrome. Neurosci Lett. 2002;323:75-77.
  • Kemler MA, Van De Vusse AC, Van Den Berg-Loonen EM, Barendse GA, Van Kleef M, Weber WE. HLA-DQ1 associated with reflex sympathetic dystrophy. Neurology. 1999;53:1350- 1351.PubMed,ChemPort,Web of Science Times Cited: 33.
  • Kingery WS. A critical review of controlled clinical trials for peripheral neuropathic pain and complex regional pain syndrome. Pain 1997;73:123-39. CrossRefMedlineWeb of Science
  • Christensen K, Jensen EM, Noer I. The reflex dystrophy syndrome response to treatment with systemic corticosteroids. Acta Chir Scand 1982;148:653-55. MedlineWeb of Science
  • PetjeG, Radler C, Aigner N, et al. Treatment of reflex sympathetic dystrophy in children using a prostacyclin analog: preliminary results. Clin Orthop Relat Res 2005; 433:178-182.
  • Goebel A, Stock M, Deacon R, et al. Intravenous immunoglobulin response and evidence for pathogenic antibodies in a case of complex regional pain syndrome 1. Ann Neurol 2005; 57:463-464
  • Wymer, James P. MD, PhD; Simpson, Jeffrey PhD; Sen, David PhD; Bongardt, Sabine MS; on behalf of the Lacosamide SP742 Study Group. Efficacy and Safety of Lacosamide in Diabetic Neuropathic Pain: An 18-week Double-blind Placebo-controlled Trial of Fixed-dose Regimens Clinical Journal of Pain: June 2009 - Volume 25 - Issue 5 - pp 376-385;
  • Bannink, I. M.J.; Vranken, J. H.; Perez, R. S.G.M.; ter Riet, S. F.; Sassen, A. M.; Zuurmond, W. W.A Treatment of CRPS type I with intravenous mannitol as an oxygen radical scavenger ; European Journal of Anaesthesiology: 2000 - Volume 17 - Issue - p 183 .
  • Bikle DD. Agents that affect bone mineral homeostasis. In: Kadzung BG, editor. Basic and clinical pharmacology, 9th ed. New York: McGraw-Hill Medical Publishing Division; 2004
  • Amit Sharma, Kayode Williams and Srinivasa N. Rajab 2006 Lippincott Williams & Wilkins Advances in treatment of complex regional pain syndrome: recent insights on a perplexing disease
  • Sigrid G. L. Fischer, et al. Anti-Inflammatory Treatment of Complex Regional Pain Syndrome. In Pain. November 2010. Vol. 151. No. 2. Pp. 251-256
  • By Steven P. Stanos, DO , Pharmacologic Therapies and Functional Restoration Techniques for CRPS RSDSA Review: 2010 Vol. 23, Issue 2;
  • M. deMos, F. J.P.M. Huygen, B.H.Ch. Stricker, J.P. Dieleman, M.C.J. M. Sturkenboom. The association between ACE inhibitors and the complex regional pain syndrome: Suggestions for a neuro-inflammatory pathogenesis of CRPS , Journal Of IASP :pain Volume 142, Issue 3 , Pages 218-224, April 2009, Received 15 August 2008; received in revised form 2 December 2008; accepted 23 December 2008. published online 05 February 2009.
  • Schwartzman RJ, Erwin KL, Alexander GM. The natural history of complex regional pain syndrome. Clin J Pain 2009; 25:273 280
  • Siddharth Kharkar, MD, MHS, Prakash Ambady, MD, Venkatesh Yedatore, MD, and Robert Schwartzman, MD, Intramuscular Botulinum Toxin A (BtxA) in complex regional pain syndrome ,Pain physician journal Pain Physician 2011; 14:311-316 • ISSN 1533-3159
  • Ian Carroll, MD, MS,1 J. David Clark, MD, PhD,2 and Sean Mackey, MD, Phd Sympathetic Block with Botulinum Toxin to Treat Complex Regional Pain Syndrome ;Ann Neurol. 2009 March; 65(3): 348-351.
  • Pam Harrison, IVIG Improves Symptoms in Refractory Complex Regional Pain Syndrome; Ann Intern Med. 2010;152:152-158. From Medscape Medical News
  • Goebel A, Baranowski A, Maurer K, Ghiai A, McCabe C, Ambler G. Intravenous immunoglobulin treatment of the complex regional pain syndrome: a randomized trial. Ann Intern Med. 2010 Feb 2;152(3):152-8.
  • Hord ED, Oaklander AL. Complex regional pain syndrome: a review of evidence-supported treatment options. Curr Pain Headache Rep. 2003 Jun;7(3):188-96
  • van Hilten BJ, van de Beek WJ, Hoff JI, Voormolen JH, Delhaas EM. Intrathecal baclofen for the treatment of dystonia in patients with reflex sympathetic dystrophy. N Engl J Med. 2000 Aug 31;343(9):625-30
  • Lynch SS, Cheng CM, Yee JL. Intrathecal ziconotide for refractory chronic pain. Ann Pharmacother. 2006 Jul-Aug;40(7- 8):1293-300
  • Lyseng-Williamson KA, Perry C. Ziconotide. CNS Drugs. 2006;20(4):331-8.
  • Besse JL, Gadeyne S, Galand-Desme S, Lerat JL, Moyen B Effect of vitamin C on prevention of complex regional pain syndrome type I in foot and ankle surgery, Foot Ankle Surg. 2009;15(4):179-82. Epub 2009 Apr 5..
  • National Pain foundation: diseases and conditions ;Complex Regional Pain Syndrome: complementary techniques.
  • JG Wilson, FCARCS and MG Serpell, FRCA ,Complex regional pain syndrome, Oxford Journals Medicine BJA: CEACCP Volume7, Issue2 Pp. 51-54
  • Kemler MA, Barendse GA, van Kleef M, et al. Spinal cord stimulation in patients with chronic reflex sympathetic dystrophy. N Engl J Med 2000;343:618-24.
  • Kemler MA, de Vet HC, Barendse GA, van den Wildenberg FA, van Kleef M. Effect of spinal cord stimulation for chronic complex regional pain syndrome Type I: five-year final followup of patients in a randomized controlled trial. J Neurosurg. 2008 Feb;108(2):292-8.
  • Stanton-Hicks M. Complex regional pain syndrome: manifestations and the role of neurostimulation in its management. J Pain Symptom Manage. 2006 Apr;31(4 Suppl):S20-4
  • Picarelli H, Teixeira MJ, de Andrade DC, Myczkowski ML, Luvisotto TB, Yeng LT, et al. Repetitive transcranial magnetic stimulation is efficacious as an add-on to pharmacological therapy in complex regional pain syndrome (CRPS) type I. J Pain. 2010 Nov;11(11):1203-10.
  • Forouzanfar T, van Kleef M, Weber WE. Radiofrequency lesions of the stellate ganglion in chronic pain syndromes: retrospective analysis of clinical efficacy in 86 patients. Clin J Pain. 2000 Jun;16(2):164-8.
  • SOURCE: Kobrossi: Photodynamic Therapy pamphlet general information on photon therapy (photodynamic therapy) article from Parc Pearl 2000 Update.
  • Angela Notarnicola, Lorenzo, Silvo Tafuri, Antonio Panella, Marco Filippon Et Al; Shockwave Therapy In The Management Of Complex Regional Pain Syndrome In Medial Femoral Condyle Of The Knee, Ultrasound in Med. & Biol., Vol. -, No. - pp. 1-6, 2010 Received 7 December 2009; revised 20 February 2010; in final form 15 March 2010)
  • MZ Kiralp, S.Yildiz, D .Vural, I. Keskin, H. and H .Dursun, Effectiveness of Hyperbaric Oxygen Therapy in the Treatment of Complex Regional Pain Syndrome; Revised The Journal of International Medical Research 2004; 32: 258 - 262 accepted 21 January 2004 Copyright © 2004 Cambridge Medical Publications
  • www.feldenkrais.com.National Pain Foundation:diseases and conditions, Complex Regional Pain Syndrome ,Physical therapies
  • Tran de QH, Duong S, Bertini P, Finlayson RJ Treatment of complex regional pain syndrome: a review of the evidence. Can J Anaesth. 2010 Feb; 57(2):149-66.
  • Watkins L. Spinal cord glia: new players in pain. Pain. 2001. 93(3): 201-205.
  • DeLeo J, Sorkin L, and Watkins L. Immune and Glial Regulation of Pain. IASP Press. Seattle. 2007
  • Costigan M, Moss A, Latremoliere A, et al. T-cell infiltration and signaling in the adult dorsal spinal
  • cord is a major contributor to neuropathic pain-like hypersensitivity. J Neuroscience. 2009. 29(46):14415-14422.
  • Analysis of Photoplethysmographic Signal in Lumbar Sympathetic Block (park001) Verified on June 2010 by Seoul National University Hospital ,ClinicalTrials.gov
  • Complex Regional Pain Syndrome - Updates and interesting information: Experts find brain enzyme that makes pain last Posted: December 2, 2010 by Louise Turner in Uncategorized Yahoo News - Article link- Thu Dec 2, 2:25 pm ET

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  • Complex Regional Pain Syndrome and its Treatment: An Overview

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Authors

D. A. Helen Sheeba
Malla Reddy Institute of Pharmaceutical Sciences, Maisammaguda, Dullapally (Post via Hakimpet), Secunderabad - 500 014, India
V. Gauthami Yadav
Malla Reddy Institute of Pharmaceutical Sciences, Maisammaguda, Dullapally (Post via Hakimpet), Secunderabad - 500 014, India

Abstract


Complex regional pain syndrome type I (CRPS type I)--formerly reflex sympathetic dystrophy (RSD)--causes chronic, poorly controllable pain, autonomic, sensorimotor disorders, and serious trophic alterations in the later stages. It develops in the distal extremities mostly after minimal trauma or surgical intervention and rarely spontaneously. The severity of symptoms is disproportionate to the causative event. The latest scientific findings show that the previously called reflex sympathetic dystrophy (RSD), which was supposed to be a result of a hyper-reactive autonomic nervous system, is a very complex syndrome that occurs on different integration levels of the nervous system. The International Association for the Study of Pain (ISAP) introduced the more descriptive term "complex regional pain syndrome" (CRPS) in 1994. Possible role of peripheral inflammatory processes, abnormal sympathetic-afferent coupling and various other novel mechanisms of patho-physiology have led to various medications ,Physical therapy, occupational therapy, and psychotherapy which play an important role in the primary treatment of CRPS as non-invasive procedures.

Keywords


Complex Regional Pain Syndrome, Neuropathic Pain, Reflex Sympathetic Dystrophy, Causalgia Treatment Advances, Peripheral Nervous System.

References