scholarly journals Venipuncture-Induced Complex Regional Pain Syndrome: A Case Report and Review of the Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Foad Elahi ◽  
Chandan G. Reddy
Keyword(s):  
Neuropathic Pain ◽  
Pain Management ◽  
Complex Regional Pain Syndrome ◽  
Upper Extremity ◽  
Early Recognition ◽  
Multidisciplinary Treatment ◽  
Pain Syndrome ◽  
Treatment Modalities ◽  
Medical Procedure ◽  
Chronic Neuropathic Pain

Venipuncture, the most frequently performed invasive medical procedure, is usually benign. Generally it produces only transitory mild discomfort. Venipuncture-induced neuropathic pain is hard to recognize at an early stage. Medical literature reviews show that there is not adequate medical knowledge about this important subject. The inciting incident in complex regional pain syndrome (CRPS) can often seem far too trivial to result in a condition with such severe pathophysiologic effects. The practicing physician has little information available to enable early recognition of the condition, initiation of multidisciplinary treatment modalities, and proper referral to pain specialists. We encountered a unique case of venipuncture-induced complex regional pain syndrome (CRPS). The patient is a 52-year-old school teacher with no significant past medical history, who presented initially to the Center of Pain Medicine with left upper extremity pain. The pain started while phlebotomy was performed in the patient’s left antecubital area for routine blood check. The patient’s pain did not improve with multiple medications, physical therapy, or several nerve blocks. The patient demonstrated all the signs and symptoms of chronic neuropathic pain of CRPS in the upper extremity with minimal response to the continuous pain management. We decided to proceed with cervical spinal cord nerve stimulation along with continuing other modalities. The patient responded to this combination. During the follow-up, we noticed that the patient’s pain course was complicated by extension of the CRPS to her lower extremity. We will describe the course of treatment for the patient in this paper. In this paper we will discuss the electrical neuromodulation as an important modality in addition to the multidisciplinary pain management for a patient with venipuncture-induced chronic neuropathic pain.

scholarly journals Still's Disease and Recurrent Complex Regional Pain Syndrome Type-I: The First Description

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
César Faillace ◽  
Jozélio Freire de Carvalho
Keyword(s):  
Neuropathic Pain ◽  
Complex Regional Pain Syndrome ◽  
Skin Color ◽  
Pain Syndrome ◽  
Type I ◽  
Still’S Disease ◽  
Chronic Neuropathic Pain ◽  
Still's Disease ◽  
First Case ◽  
Psychiatric Conditions

Complex regional pain syndrome (CRPS) is a chronic neuropathic pain disorder characterized by neuropathic pain associated with local edema and changes suggestive of autonomic involvement such as altered sweating, skin color, and skin temperature of the affected region. CRPS was described associated with several diseases, such as trauma, psychiatric conditions, and cancer. However, no case associated with Still's disease has been previously described. In this paper, the authors describe the first case of CRPS associated with Still's disease.

Pediatric Complex Regional Pain Syndrome: Stellate Ganglion and Lumbar Sympathetic Blocks

2021 ◽  
pp. 167-174
Author(s):  
Sarah Choxi
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Early Recognition ◽  
Multidisciplinary Treatment ◽  
Stellate Ganglion ◽  
Pain Syndrome ◽  
Signs And Symptoms ◽  
Nerve Blocks ◽  
Distal Extremity ◽  
Peripheral Nerve Blockade ◽  
Sympathetic Blocks

Complex regional pain syndrome (CRPS) is a chronic, localized pain condition following an injury, typically affecting a distal extremity. Although the pathophysiology of CRPS is unclear, multiple mechanisms are implicated, including peripheral and central sensitization as well as sympathetically mediated pain. Peripheral nerve blockade can treat the somatic component of CRPS pain, while sympathetic blockade may alleviate pain that is sympathetically mediated. Signs and symptoms manifest as abnormal sensory, motor, vasomotor, and sudomotor changes that are disproportionate to the inciting event. Early recognition of the signs and symptoms, followed by rapid implementation of a multidisciplinary treatment approach—including physical therapy, psychotherapy, pharmacotherapy, and sympathetic nerve blocks, is a major factor in improving outcome and preventing treatment-resistant CRPS.

scholarly journals Use of Stellate Ganglion Local Anesthetic Blockade for Treatment of Complex Regional Pain Syndrome Type-II of the Upper Extremity: A Case Report of One Patient’s Experience after Traumatic Hand Injury

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Ahmad S ◽  
◽  
Sabia M ◽  
Keyword(s):  
Neuropathic Pain ◽  
Complex Regional Pain Syndrome ◽  
Upper Extremity ◽  
Stellate Ganglion ◽  
Stellate Ganglion Block ◽  
Pain Syndrome ◽  
Syndrome Type ◽  
Type Ii ◽  
Ganglion Block ◽  
Cord Injury

Background: Complex Regional Pain Syndrome (CRPS) is a neuropathic pain syndrome associated with edema, muscle weakness, and hyperhidrosis. It can be precipitated by fracture, surgery, and spinal cord injury and usually involves the ipsilateral and sometimes contralateral extremity. Case Details: A 47-year-old male with CRPS Type-II involving the upper extremity had severe neuropathic pain that was limiting his ADLs despite medical, physical and occupational therapy. This case discusses the use of stellate ganglion block in the treatment of upper extremity CRPS Type-II. Conclusion: Stellate ganglion blockade is an effective adjuvant therapy in the treatment of CRPS Type-II when conservative therapy has failed to provide improvement in pain, highlighting a need for a multimodal therapeutic strategy. Keywords: Stellate ganglion block; Chronic pain; Complex regional pain syndrome type-II; Bupivacaine

Complex regional pain syndrome type I as a consequence of trauma or surgery to upper extremity: management with intravenous regional anaesthesia, using lidocaine and methyloprednisolone

2011 ◽  
Vol 36 (9) ◽  
pp. 771-777 ◽  
Author(s):  
S. E. Varitimidis ◽  
L. K. Papatheodorou ◽  
Z. H. Dailiana ◽  
L. Poultsides ◽  
K. N. Malizos
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Upper Extremity ◽  
Early Recognition ◽  
Pain Syndrome ◽  
Type I ◽  
Syndrome Type ◽  
End Of Treatment ◽  
Anaesthetic Block ◽  
Intravenous Regional Anaesthesia

Complex regional pain syndrome type I (CRPS-I) is a known complication after surgery or trauma to the upper extremity and is difficult to treat. A simple and easily tolerated method of treatment that includes intravenous regional anaesthetic block with lidocaine and methyloprednisolone is presented. One hundred and sixty-eight patients with CRPS-I of the upper extremity were treated in a 5-year period. At the end of treatment 88% of the patients reported minimal or no pain. After a mean follow-up of 5 years (range 28 months to 7 years) complete absence of pain was reported by 92% of patients. The symptoms of the acute phase of the syndrome were reversed. Early recognition and prompt initiation of treatment is very important for the course of the disease as symptoms can be reversible when treatment starts early. Permanent results with a functional upper extremity and very satisfactory pain relief can be anticipated.

scholarly journals Asymmetrical Uptakes in 99m Tc MDP Bone Scan in Upper Extremity in Patient with Prostate Cancer: an Interesting Case

2018 ◽  
Vol 19 (2) ◽  
pp. 152
Author(s):  
Pupree Mutsuddy ◽  
Shamim MF Begum ◽  
Rahima Perveen ◽  
Mohammad Simoon Salekin
Keyword(s):  
Prostate Cancer ◽  
Complex Regional Pain Syndrome ◽  
Upper Extremity ◽  
Bone Scan ◽  
Pain Syndrome ◽  
Interesting Case ◽  
Skeletal Scintigraphy ◽  
Methylene Diphosphonate

<p>Asymmetrical uptake of 99m Tc MDP (methylene diphosphonate) in skeletal scintigraphy in extremity may lead to confusion in the diagnosis of metastasis or complex regional pain syndrome. After the exclusion of possible contamination in this report a case was presented with asymmetrical uptake of MDP in the upper extremity from accidental intra-arterial injection.</p><p>Bangladesh J. Nuclear Med. 19(2): 152-154, July 2016</p>

scholarly journals Complex Regional Pain Syndrome: Current Practice Management and Referral Trends in a Closed Healthcare System

Osteology ◽  
2020 ◽  
Vol 1 (1) ◽  
pp. 39-47
Author(s):  
Connor Zale ◽  
Joshua Hansen ◽  
Paul Ryan
Keyword(s):  
Pain Management ◽  
Pain Score ◽  
Complex Regional Pain Syndrome ◽  
Healthcare System ◽  
Pain Syndrome ◽  
Occupational Outcomes ◽  
Mean Delay ◽  
Significant Difference ◽  
The Mean ◽  
Over Time

Background: Complex regional pain syndrome (CRPS) is a neurologic condition that can present with severe pain and dysfunction. Delay in treatment adversely affects outcomes. The purpose of this study is to evaluate patient outcomes as they relate to the time from diagnosis to pain management referral once the diagnosis of CRPS has been made in a closed healthcare system. Methods: A retrospective record review from a closed healthcare system was utilized for CRPS cases from 2010–2019. Demographics, injury pattern, surgeries, pain score, treatment modalities, occupational outcomes, and time to pain management referral were recorded. Results: There were 26 cases of CRPS that met inclusion criteria. The mean time from diagnosis to treatment was 55 days. 16/26 (61.5%) were medically discharged from the military. 23/26 (88.5%) were unable to return to full duty due to CRPS. There was no significant difference in the reported pain scores over time regardless of treatment (p = 0.76). A linear regression demonstrated a significantly higher Visual Analog Scale Pain Score (VAS) over time in patients that were medically discharged (p = 0.022). Conclusions: The mean delay in referral to the pain service was 55 days. The majority of patients (88.5%) did not return to full duty secondary to the diagnosis of CRPS, and 61.5% of patients required medical separation from active duty. Due to the negative impact that the diagnosis of CRPS has on occupational outcomes with a mean delay in referral of 55 days, clinics and providers should set up referral criteria and establish early pain pathways for patients diagnosed with CRPS.

First experience with chronic epidural spinal cord stimulation in Khanty-Mansi autonomous okrug — clinical observations

2021 ◽  
Vol LIII (2) ◽  
pp. 94-100
Author(s):  
Olga A. Bondarenko ◽  
Gaspar V. Gavrilov ◽  
Vadim A. Padurets ◽  
Roman V. Kasich
Keyword(s):  
Spinal Cord ◽  
Neuropathic Pain ◽  
Spinal Cord Stimulation ◽  
Pain Syndrome ◽  
Chronic Neuropathic Pain ◽  
Neuropathic Pain Syndrome ◽  
Epidural Stimulation ◽  
Cord Injury ◽  
Epidural Spinal Cord Stimulation ◽  
And Migration

Purpose of the work. The article is devoted to the first experience of epidural stimulation in the Khanty-Mansiysk Autonomous Okrug at the budgetary institution Surgut Clinical Trauma Hospital. Clinical examples are presented for two main indications for the application of this technique (disease of the operated spine, a consequence of spinal cord injury in combination with chronic neuropathic pain syndrome). Research methods. An assessment of the intensity of pain syndrome was given according to a visual analogue scale, the Pain Detect questionnaire; indicators of anxiety, depression on the HADS scale; quality of life according to the Oswestry questionnaire for a follow-up period of 6-12 months in patients with chronic epidural stimulation. Results. A positive assessment of the action during test neurostimulation was 63.3% (38 patients). Of the established permanent systems, a good result was achieved and persisted for 12 months or more in 96% (24 patients). It was necessary to change the stimulation parameters in 13% (3 patients). Revision of permanent systems was performed in 20% (5 patients), due to the progression of the degenerative-dystrophic process of the spine, damage and migration of system elements. Conclusions. Chronic epidural spinal cord stimulation has established itself as a personalized, highly effective, minimally invasive and safe method of treating chronic neuropathic pain syndromes. Multicomponent corrective action is of scientific interest and requires further study.

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