Pharmacologic Management of Complex Regional Pain Syndrome

@article{Rowbotham2006PharmacologicMO,
  title={Pharmacologic Management of Complex Regional Pain Syndrome},
  author={Michael C. Rowbotham},
  journal={The Clinical Journal of Pain},
  year={2006},
  volume={22},
  pages={425-429}
}
  • M. Rowbotham
  • Published 1 June 2006
  • Medicine
  • The Clinical Journal of Pain
Few randomized controlled trials of oral pharmacotherapy have been performed in patients with complex regional pain syndrome (CRPS). The prevalence of CRPS is uncertain. Severe and advanced cases of CRPS are easily recognized but difficult to treat and constitute a minority compared with those who meet minimum criteria for the diagnosis. Unsettled disability or liability claims limit pharmaceutical industry interest in the disorder. Many studies are small or anecdotal, or are reported on only… Expand
Practical Management of Complex Regional Pain Syndrome
  • E. Hsu
  • Medicine
  • American journal of therapeutics
  • 2009
TLDR
An interdisciplinary setting with comprehensive approach (pharmacologic, interventional, and psychological in conjunction with rehabilitation pathway) has been proposed as protocol in the practical management of CRPS to facilitate further research to enhance clinical outcome including quality of life. Expand
Intravenous Immunoglobulin Treatment of the Complex Regional Pain Syndrome
TLDR
IVIG, 0.5 g/kg, can reduce pain in refractory CRPS, and studies are required to determine the best immunoglobulin dose, the duration of effect, and when repeated treatments are needed. Expand
Prolonged ketamine infusion as a therapy for complex regional pain syndrome: synergism with antagonism?
TLDR
The arguments for a role of prolonged ketamine infusion in the management of neuropathic pain and specifically for CRPS are articulated, and graded motor imagery, mirror visual feedback, spinal cord stimulation and transcranial magnetic stimulation are outlined. Expand
Pharmacotherapy options for complex regional pain syndrome
TLDR
Control trials have demonstrated that a short course of oral corticosteroids, intranasal or intramuscular calcitonin, intravenous bisphosphonates, free-radical scavengers, gabapentin, regional intravenous sympathetic blocks with bretylium and spinal cord stimulation or physical therapy and occupational therapy can be efficacious for complex regional pain syndrome. Expand
Plasma Exchange Therapy in Patients with Complex Regional Pain Syndrome.
TLDR
This study shows that PE is effective in a subset of patients with severe long-standing CRPS and that the reduction in pain following the initial series of PE treatments can be maintained on a weekly PE schedule, IVIG, or with other immune modulating drugs. Expand
Treatment of complex regional pain syndrome in adults: A systematic review of randomized controlled trials published from June 2000 to February 2012
TLDR
The observed phenomenon of excellent responses in CRPS subgroups would support the case for a network‐ and multi‐centre approach in the conduct of future clinical trials and the heterogeneity of trialled interventions militate against drawing clear conclusions about the clinical usefulness of most interventions. Expand
Four treatment strategies for complex regional pain syndrome type 1.
TLDR
A protocol including a combination of IV 20% mannitol and steroid with oral gabapentin is an acceptable and effective treatment for CRPS type 1. Expand
Can vitamin C prevent complex regional pain syndrome in patients with wrist fractures? A randomized, controlled, multicenter dose-response study.
TLDR
Vitamin C reduces the prevalence of complex regional pain syndrome after wrist fractures and a daily dose of 500 mg for fifty days is recommended. Expand
Complex regional pain syndrome: a review.
TLDR
There is very little good evidence in the literature to guide treatment of CRPS, and early recognition and a multidisciplinary approach to management seems important in obtaining a good outcome. Expand
Long-term Outcomes Using Intrathecal Drug Delivery Systems in Complex Regional Pain Syndrome
TLDR
The findings suggest that intrathecal opiates may not be effective in reducing oral opiate intake, ziconotide may hasten a decrease in intake, and bupivacaine may lead to an increase in intake. Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 53 REFERENCES
Treatment of complex regional pain syndrome type I
TLDR
A review of existing randomized controlled trials of therapies forlex sympathetic dystrophy resulted in two eligible studies, one of high quality and dealt with different interventions and the other of limited evidence for their preventive effect. Expand
A critical review of controlled clinical trials for peripheral neuropathic pain and complex regional pain syndromes
TLDR
A meta‐analysis of the controlled clinical trial data for peripheral neuropathic pain (PNP) and complex regional pain syndromes (CRPS) indicated that mexiletine and intravenous morphine were probably effective analgesics for PNP, while non‐steroidals were probably ineffective. Expand
Gabapentin dosing for neuropathic pain: evidence from randomized, placebo-controlled clinical trials.
BACKGROUND Pain is one of the most common reasons for seeking medical attention, and neuropathic pain is among the most common types of pain. Despite its prevalence, neuropathic pain is oftenExpand
The treatment of complex regional pain syndrome type I with free radical scavengers: a randomized controlled study
TLDR
Treatment with DMSO and NAC are generally equally effective in treatment of complex regional pain syndrome I, and strong indications exist for differences in effects for subgroups of patients with warm or coldCRPS I: for warm CRPS I, D MSO‐treatment appears more favorable, while for cold CR PS I, NAC‐ treatment appears to be more effective. Expand
Oral opioid therapy for chronic peripheral and central neuropathic pain.
TLDR
The reduction in the intensity of neuropathic pain was significantly greater during treatment with higher doses of opioids than with lower doses, and higher doses produced more side effects without significant additional benefit in terms of other outcome measures. Expand
Bisphosphonate therapy of reflex sympathetic dystrophy syndrome
TLDR
Results indicate that bisphosphonates should be considered for the treatment of RSDS, producing consistent and rapid remission of the disease. Expand
Controlled-release oxycodone for pain in diabetic neuropathy
TLDR
In this 6-week trial, CR oxycodone was effective for the treatment of moderate to severe pain due to diabetic neuropathy and the most common adverse events were opioid related. Expand
Efficacy of oxycodone in neuropathic pain: a randomized trial in postherpetic neuralgia.
TLDR
Controlled-release oxycodone is an effective analgesic for the management of steady pain, paroxysmal spontaneous pain, and allodynia, which frequently characterize postherpetic neuralgia. Expand
Intravenous clodronate in the treatment of reflex sympathetic dystrophy syndrome. A randomized, double blind, placebo controlled study.
TLDR
A 10 day i.v. clodronate course is better than placebo and effective in the treatment of RSDS and NTx seems to be a predictive factor for clodonate efficacy. Expand
Concentration–Effect Relationship of Intravenous Lidocaine on the Allodynia of Complex Regional Pain Syndrome Types I and II
TLDR
It is demonstrated that intravenous lidocaine affects pain in response to cool stimuli more than mechanical pain in subjects with neuropathic pain. Expand
...
1
2
3
4
5
...