Role of affective instability on suicidal risk in complex regional pain syndrome: a diary approach (preliminary report)

Venipuncture is one of the most commonly done medical procedures. We report a unique case of a 23-year-old young male who presented with features suggestive of inflammatory arthritis. The symptoms, which initially started on the right side, also involved the other side after a few weeks. Although the patient’s symptoms and signs were simulating inflammatory arthritis, he had atypical features like poor response to anti-inflammatory medicines and normal laboratory parameters. His musculoskeletal ultrasonography was also not suggestive of arthritis. His history was reviewed and on direct questioning he revealed a history of venipuncture for blood sample withdrawal, done from right antecubital region for routine health check on the day prior to the onset of symptoms. Complex regional pain syndrome was suspected and triple-phase radioisotope bone scan was done which was highly suggestive of this diagnosis. The patient was managed with multidimensional approach and responded very well to the treatment. Complex regional pain syndrome is usually not thought of in the initial differential diagnosis of inflammatory arthritis. In this report we highlight the need to elicit the often overlooked history of trivial trauma like venipuncture, especially in atypical cases of arthritis. Also the role of newer diagnostic modalities in such cases is emphasized.

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Increased calcium-mediated cerebral processes after peripheral injury: possible role of the brain in complex regional pain syndrome

The Korean Journal of Pain ◽

10.3344/kjp.2020.33.2.131 ◽

2020 ◽

Vol 33 (2) ◽

pp. 131-137

Author(s):

Francis Sahngun Nahm ◽

Jae-Sung Lee ◽

Pyung-Bok Lee ◽

Eunjoo Choi ◽

Woong Ki Han ◽

...

Keyword(s):

Complex Regional Pain Syndrome ◽

Pain Syndrome ◽

Peripheral Injury ◽

The Brain

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CRPS: what’s in a name? Taxonomy, epidemiology, neurologic, immune and autoimmune considerations

Regional Anesthesia and Pain Medicine ◽

10.1136/rapm-2018-100064 ◽

2019 ◽

Vol 44 (3) ◽

pp. 376-387 ◽

Cited By ~ 5

Author(s):

Michael d‘A Stanton-Hicks

Keyword(s):

Nervous System ◽

Autonomic Nervous System ◽

Complex Regional Pain Syndrome ◽

Severity Score ◽

Clinical Management ◽

Pain Syndrome ◽

Clinical Syndromes ◽

Shed Light ◽

Historical Origins

This account of the condition now termed complex regional pain syndrome (CRPS) spans approximately 462 years since a description embodying similar clinical features was described by Ambroise Paré in 1557. While reviewing its historical origins, the text describes why it became necessary to change the taxonomies of two clinical syndromes with similar pathophysiologies to one which acknowledges this aspect but does not introduce any mechanistic overtones. Discussed at length is the role of the sympathetic component of the autonomic nervous system (ANS) and why its dysfunction has both directly and indirectly influenced our understanding of the inflammatory aspects of CRPS. As the following article will show, our knowledge has expanded in an exponential fashion to include musculoskeletal, immune, autoimmune, central and peripheral nervous system and ANS dysfunction, all of which increase the complexity of its clinical management. A burgeoning literature is beginning to shed light on the mechanistic aspects of these syndromes and the increasing evidence of a genetic influence on such factors as autoimmunity, and its importance is also discussed at length. An important aspect that has been missing from the diagnostic criteria is a measure of disease severity. The recent validation of a CRPS Severity Score is also included.

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The Role of Periaqueductal Gray and Cingulate Cortex During Suppression of Pain in Complex Regional Pain Syndrome

Clinical Journal of Pain ◽

10.1097/ajp.0b013e31821d9063 ◽

2011 ◽

Vol 27 (9) ◽

pp. 796-804 ◽

Cited By ~ 18

Author(s):

Wolfgang Freund ◽

Arthur P. Wunderlich ◽

Gregor Stuber ◽

Florian Mayer ◽

Peter Steffen ◽

...

Keyword(s):

Complex Regional Pain Syndrome ◽

Pain Syndrome ◽

Cingulate Cortex ◽

Periaqueductal Gray

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The role of enhanced cutaneous IL-1β signaling in a rat tibia fracture model of complex regional pain syndrome

Pain ◽

10.1016/j.pain.2009.04.033 ◽

2009 ◽

Vol 144 (3) ◽

pp. 303-313 ◽

Cited By ~ 59

Author(s):

Wen-wu Li ◽

Ilya Sabsovich ◽

Tian-Zhi Guo ◽

Rong Zhao ◽

Wade S. Kingery ◽

...

Keyword(s):

Complex Regional Pain Syndrome ◽

Pain Syndrome ◽

Tibia Fracture ◽

Fracture Model ◽

Rat Tibia

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Update on the pathogenesis of complex regional pain syndrome: Role of oxidative stress

Canadian Journal of Anesthesia/Journal canadien d anesthésie ◽

10.1007/s12630-012-9748-y ◽

2012 ◽

Vol 59 (9) ◽

pp. 875-881 ◽

Cited By ~ 20

Author(s):

Rame Taha ◽

Gilbert A. Blaise

Keyword(s):

Oxidative Stress ◽

Complex Regional Pain Syndrome ◽

Pain Syndrome

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

The Scientific World JOURNAL ◽

10.1100/tsw.2008.33 ◽

2008 ◽

Vol 8 ◽

pp. 229-236 ◽

Cited By ~ 19

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.

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