Complex Regional Pain Syndrome (CRPS) after viper-bite in a pregnant young woman: Pathophysiology and treatment options

2016 ◽  
Vol 10 (1) ◽  
pp. 108-110
Author(s):  
Harald Breivik ◽  
Audun Stubhaug
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Young Woman ◽  
Treatment Options ◽  
Pain Syndrome

scholarly journals Complex Regional Pain Syndrome (CRPS/RSD) and Neuropathic Pain: Role of Intravenous Bisphosphonates as Analgesics

2008 ◽  
Vol 8 ◽  
pp. 229-236 ◽  
Author(s):  
Jennifer Yanow ◽  
Marco Pappagallo ◽  
Letha Pillai
Keyword(s):  
Clinical Trials ◽  
Neuropathic Pain ◽  
Animal Models ◽  
Complex Regional Pain Syndrome ◽  
Bone Pain ◽  
Treatment Options ◽  
Pain Syndrome ◽  
Pain Pathways ◽  
Intravenous Bisphosphonates

Neuropathic pain is a sequela of dysfunction, injuries, or diseases of the peripheral and/or central nervous system pain pathways, which has historically been extremely difficult to treat. Complex regional pain syndrome (CRPS) types 1 and 2 are neuropathic pain conditions that have a long history in the medical literature but whose pathophysiology remains elusive and whose available treatment options remain few. While an exact animal model for CRPS doesn't yet exist, there are several animal models of neuropathic pain that develop behaviors of hypersensitivity, one of the hallmark signs of neuropathic pain in humans.Bisphosphonates have been used for pathologic conditions associated with abnormal bone metabolism, such as osteoporosis, Paget’s disease and cancer-related bone pain for many years. More recently, results of clinical trials have indicated the potential role of bisphosphonates in the treatment of CRPS/RSD.In this paper we will review the preclinical studies regarding the use of bisphosphonates as analgesics in animal models of neuropathic pain, and also summarize the clinical trials that have been done to date. We will give an overview of bisphosphonate pharmacology and discuss several potential mechanisms by which bisphosphonates may be analgesic in CRPS/RSD and bone pain of noncancer origin.

scholarly journals Spinal Cord Stimulation for Complex Regional Pain Syndrome: A Case Study of a Pregnant Female

2016 ◽  
Vol 3;19 (3;3) ◽  
pp. E487-E493
Author(s):  
Shaik Ahmed
Keyword(s):  
Spinal Cord ◽  
Complex Regional Pain Syndrome ◽  
Spinal Cord Stimulation ◽  
Treatment Options ◽  
Pain Syndrome ◽  
Conclusive Evidence ◽  
Treatment Modalities ◽  
Child Bearing ◽  
The Impact

Background: Spinal cord stimulation (SCS) is a form of neuromodulation, used to treat chronic neuropathic pain refractory to conventional medical management. Spinal cord stimulators are treatment options when intractable chronic pain has not responded to more conventional treatment modalities. Currently, the use of SCS is contraindicated in pregnancy. Nevertheless, many SCS/ neuromodulation recipients are women of child bearing age who may become pregnant. There are no published reports that focus on the possible side effects of SCS or neuromodulation therapy on human fertility, fetal development, pregnancy, delivery, or lactation. Objectives: The purpose of this current report is to present a case study on the use of SCS/ neuromodulation during pregnancy. Study Design: Presentation of the case of a 24 year old female who became pregnant after receiving an SCS implantation for pain control secondary to complex regional pain syndrome (CRPS). The SCS was in use at the time of conception but deactivated when patient became aware of her pregnancy and intermittently reactivated for five minute intervals throughout the entire pregnancy. Results: Currently very little documented evidence is available regarding the safety of using a SCS/ neuromodulator during pregnancy; therefore its use during pregnancy is contraindicated. Available literature suggests that, women who have chosen to keep the SCS/neuromodulator activated during pregnancy have delivered healthy babies without any life threatening complications. Limitations: Case presentations do not provide conclusive evidence of treatment effectiveness. This data is only preliminary and future studies should be used to assess outcomes and measures to provide quantification of the SCS implantation during pregnancy. Conclusions: Women of child bearing age who are recipients of SCS/neuromodulation implantation should be informed of the limited knowledge available regarding the impact of SCS/ neuromodulation use during pregnancy. For current recipients, decisions about ongoing use during pregnancy should be an individual decision based on the potential risks and benefits. Key words: Pregnancy and complex regional pain syndrome, pregnancy and reflex sympathetic dystrophy, pregnancy and spinal cord stimulators, pregnancy and electromagnetic fields, and pregnancy and neuromodulator.

Pediatric Complex Regional Pain Syndrome Type 1

2018 ◽  
Author(s):  
Bobbie Riley ◽  
Navil Sethna
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Diagnostic Tests ◽  
Treatment Options ◽  
Pain Syndrome ◽  
Underlying Mechanism ◽  
Interventional Treatment ◽  
Syndrome Type ◽  
Delay In Diagnosis ◽  
Skin Hypersensitivity

Complex regional pain syndrome type 1 (CRPS-1) is a condition that affects adolescents and children under the age of 7. It usually follows minor injury and rarely occurs spontaneously. The pain is usually out of proportion to the inciting injury. Pain, allodynia, and/or hyperalgesia are severe enough to inhibit use of the affected limb. Delay in diagnosis and self and/or iatrogenic immobilization of the affected limb may lead to worsening pain, skin hypersensitivity and discoloration, swelling, and vasomotor and dystrophic abnormalities. The diagnosis of CRPS-1 and 2 is based on symptoms. There are no diagnostic tests that can confirm the presence or absence of CRPS-1. CRPS-2 diagnosis is established by nerve conduction test and electromyography. Clinical practice neuropathic guidelines are most effective for CRPS-2 treatment. Pharmacological and interventional treatment options for CRPS-1 are limited and usually ineffective because the underlying mechanism(s) are yet to be determined.

Complex regional pain syndrome: An updated comprehensive review

2020 ◽  
Vol 47 (3) ◽  
pp. 253-264
Author(s):  
Allison Kessler ◽  
Min Yoo ◽  
Randy Calisoff
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Treatment Options ◽  
Interdisciplinary Approach ◽  
Clinical Information ◽  
Pain Syndrome ◽  
Definitive Treatment ◽  
Confirmatory Test ◽  
Exact Etiology ◽  
Behavioral Therapies ◽  
Budapest Criteria

Complex regional pain syndrome (CRPS) is a complex disorder that can have a significant impact on the quality of life of a person with this syndrome. The diagnosis and treatment of CRPS are often difficult as there is no one confirmatory test and no one definitive treatment. Currently, the most widely accepted clinical diagnostic criteria are the Budapest criteria, which were developed by expert consensus. Though no one single treatment has been found to be universally effective, early detection and an interdisciplinary approach to treatment appear to be key in treating CRPS. This review aims to present up-to-date clinical information regarding the diagnosis and management of CRPS and highlight the potential issues with diagnosis in the neurological population. Ultimately, more research is needed to identify the exact etiology of CRPS in order to help target appropriate therapies. In addition, more randomized controlled trials need to be performed in order to test new therapies or combinations of therapies, including pharmacological, interventional, and behavioral therapies, to determine the best treatment options for this potentially debilitating disorder.

scholarly journals How to treat complex regional pain syndrome in rehabilitation settings?

2013 ◽  
Vol 60 (1) ◽  
pp. 69-75 ◽  
Author(s):  
Una Nedeljkovic
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Functional Limitations ◽  
Treatment Options ◽  
Pain Syndrome ◽  
Optimal Recovery ◽  
Diagnosis And Treatment ◽  
Pain Condition ◽  
Rehabilitation Outcomes ◽  
Therapy Guidelines

Complex regional pain syndrome is chronic neuropatic pain condition which usually arise after trauma. It is associated with some of the sensory, vasomotor, sudomotor, motor and trophic symptoms and sings. Due to variability of symptoms and long-lasting pain, these patients are hard to rehabilitate. They exhibit activity related fear and so have pronounced functional limitations. Adequate rehabilitation procedures, frequently long lasting, are essential for their optimal recovery, so rehabilitation specialist should constantly update their knowledge on this issue. Emerging researches on pathophysiology, diagnosis and treatment of CRPS created a need for systematization of current body of evidence. Available researches on efficacy of different treatment options are still insufficient to create precise therapy guidelines, so future researches are needed in order to promote better rehabilitation outcomes.

IV Ketamine-Induced Skin Temperature Changes in a Patient with Unilateral Complex Regional Pain Syndrome (CRPS) Type II

2020 ◽  
pp. 157-162
Author(s):  
Ashraf F. Hanna
Keyword(s):  
Skin Temperature ◽  
Complex Regional Pain Syndrome ◽  
Treatment Options ◽  
Functional Decline ◽  
Pain Syndrome ◽  
The Novel ◽  
Vascular Effects ◽  
Temperature Changes ◽  
Vascular Abnormalities ◽  
Skin Temperatures

Background: Ketamine is increasingly being utilized off-label for numerous difficult-to-treat conditions when conservative treatment options fail to provide an adequate clinical response. One such condition is complex regional pain syndrome (CRPS). CRPS is characterized by pain, inflammation, vascular abnormalities, and functional decline. While ketamine has been used successfully to treat the disease, its mechanism of action remains hotly debated and not well-understood. Case Report: Here, we describe a clinical case of CRPS in a female patient who was refractory to conventional treatment options. Skin temperatures were measured in the affected and unaffected limb before, during, and after intravenous infusion with ketamine. We report that skin temperature increased in the CRPS-affected limb despite the known sympathomimetic effects of ketamine expected to produce vasoconstriction. Conclusion: The novel findings presented herein are intended to spur formal well-controlled and powered clinical studies, which may better elucidate the vascular effects of ketamine in this underserved patient population. Key words: Complex regional pain syndrome, depression, esketamine, ketamine hydrochloride, suicidality, thermal imaging

Complex Regional Pain Syndrome, Current Concepts and Treatment Options

2018 ◽  
Vol 22 (2) ◽  
Author(s):  
Ivan Urits ◽  
Abra H. Shen ◽  
Mark R. Jones ◽  
Omar Viswanath ◽  
Alan D. Kaye
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Treatment Options ◽  
Pain Syndrome

scholarly journals Complex regional pain syndrome

2011 ◽  
Vol 44 (02) ◽  
pp. 298-307
Author(s):  
Sandeep J Sebastin
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Motor Function ◽  
Reflex Sympathetic Dystrophy ◽  
Treatment Options ◽  
Pain Syndrome ◽  
Hand Surgery ◽  
Limited Evidence ◽  
Laboratory Findings ◽  
Operative Care ◽  
Specific Diagnostic Test

ABSTRACTComplex regional pain syndrome (CRPS) previously known as reflex sympathetic dystrophy is a chronic neurological disorder involving the limbs characterized by disabling pain, swelling, vasomotor instability, sudomotor abnormality, and impairment of motor function. CRPS is not uncommon after hand surgery and may complicate post-operative care. There is no specific diagnostic test for CRPS and the diagnosis is based on history, clinical examination, and supportive laboratory findings. Recent modifications to diagnostic criteria have enabled clinicians to diagnose this disease more consistently. This review gives a synopsis of CRPS and discusses the diagnosis, pathophysiology, and treatment options based on the limited evidence in the literature.

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