Systemic Complications of Complex Regional Pain Syndrome

  title={Systemic Complications of Complex Regional Pain Syndrome},
  author={Robert Jay Schwartzman},
  journal={Neuroscience and Medicine},
  • R. Schwartzman
  • Published 21 September 2012
  • Medicine
  • Neuroscience and Medicine
Complex Regional Pain Syndrome (CRPS) is a neuropathic pain disorder that is characterized by: 1) Severe pain beyond the area of injury; 2) Autonomic dysregulation; 3) Neuropathic edema; 4) A movement disorder, atrophy and dystrophy. It is most often caused by a fracture, soft-tissue injury or surgical procedure and is divided into Type I, in which no nerve lesion is identified (classic reflex sympathetic dystrophy), and Type II where a specific nerve has been damaged (causalgia). In addition… 
Pain in the Complex Regional Pain Syndrome Rehabilitation Patient
Though effective relief of CRPS symptoms can be challenging, particularly in later stages of its progression, patients have obtained pain relief and functional improvements with various treatments, which include the following: physical modalities, such as physical therapy, mirror therapy, pharmacological treatments, and psychological treatments.
Posttraumatic Complex Regional Pain Syndrome and Related Comorbidities
The patient presented in this study was a female with a history of metabolic syndrome, diagnosed with polyarticular chronic gout, which despite the specific drug treatment administered, had multiple predisposing factors for the development of CRPS consecutive to the fracture of both bones of the right forearm.
CRPS-related neurogenic edema responsive to dextromethorphan/quinidine.
The pathophysiology of CRPS remains unknown, but potential mechanisms include injury to C- and A-delta sensory nerve fibers resulting in neurogenic inflammation and central sensitization, and inflammation spreads up the neuraxis, correlating with spread of pain beyond the site of injury.
Rehabilitation of complex regional pain syndrome: evidence based or trial and error?
Challenges in trying to implement timely and evidence-based rehabilitation techniques within the CRPS type I scenario are discussed and recent clinical and research advances that have sought to address some of these problems are considered.
Battling Complex Regional Pain Syndrome (CRPS): A Phenomenological Study
This research suggests that people living with CRPS are facing a daily battle to live their lives, as they face all the difficulties of living with a chronic pain condition alongside additional problems unique to CRPS.
Successful Treatment of Long Standing Complex Regional Pain Syndrome with Hyperbaric Oxygen Therapy
This case is unique in that it shows that HBOT can be effective in long-standing CRPS, both initially, and for subsequent flares, and adds to the evidence supporting HBOT as a potential treatment for this condition.
Compassionate Care for Patients With Complex Regional Pain Syndrome
Respondents expressed a variety of emotions when asked about their healthcare experiences, which suggests that healthcare providers need to be better educated about CRPS so they can provide more compassionate care for patients trying to cope with this condition.
The Neuroinflammatory Etiopathology of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)
These processes collectively enhance the potential for multi-systemic disarray involving endocrine pathway aberration, immune and mitochondrial dysfunction, and neurodegeneration, and tend toward still more intractable synergistic neuro-glial dysfunction (gliopathy), autoimmunity, and central neuronal sensitization.
Complex regional pain syndrome and dysautonomia in a 14‐year‐old girl responsive to therapeutic plasma exchange
Although further studies are needed, TPE (in combination with immunosuppression) may be an appropriate therapy for CRPS patients with detectable autoantibodies, as it is for better characterized diseases with autoant ibodies against neuronal surface receptors such as myasthenia gravis or Lambert EatonMyasthenic syndrome.
Management of Urinary and Fecal Incontinence in Patients With Complex Regional Pain Syndrome
There was significant hesitation from the provider and patient to use invasive treatments for incontinence symptoms when the patient's pain symptoms have been well controlled with an existing spinal device, however, in this patient with type 1 CRPS, even in the setting of anexisting spinal cord stimulator, sacral neuromodulation therapy was an effective treatment.


Clinical features and pathophysiology of complex regional pain syndrome
Complex regional pain syndrome type I (RSD)
In chronic RSD, efferent nerve fibers were histologically unaffected; from afferent fibers, only C-fibers showed histopathologic abnormalities.
Complex regional pain syndrome
  • F. Birklein
  • Medicine, Psychology
    Journal of Neurology
  • 2005
Major mechanism for CRPS symptoms, which might be present subsequently or in parallel during the course of CRPS, are trauma-related cytokine release, exaggerated neurogenic inflammation, sympathetically maintained pain and cortical reorganisation in response to chronic pain (neuroplasticity).
Is reflex sympathetic dystrophy/complex regional pain syndrome type I a small‐fiber neuropathy?
This work proposes that persistent RSD/CRPS‐I is a post‐traumatic neuralgia associated with distal degeneration of small‐diameter peripheral axons, and small distal nerve injuries in rodents reproduce many CRPS features, further supporting this hypothesis.
The use of ketamine in complex regional pain syndrome: possible mechanisms
Complex regional pain syndrome is a neuropathic pain syndrome that is characterized by: severe pain beyond the area of injury; autonomic dysregulation; neurogenic edema; movement disorder; and
Reflex sympathetic dystrophy: complex regional pain syndrome type I in children with mitochondrial disease and maternal inheritance
In one tertiary-care paediatric genetics practice, children meeting the CRPS-I diagnostic criteria frequently had additional autonomic-related conditions secondary to maternally inherited mitochondrial disease, suggesting that mitochondrial DNA sequence variants can predispose children towards the development of CR PSI and other dysautonomias.
Complex regional pain syndrome with associated chest wall dystonia: a case report
A patient with long standing CRPS after a brachial plexus injury, who after displaying several features of the movement disorder previously, developed painful dystonia of chest wall musculature is presented.
Vascular abnormalities in reflex sympathetic dystrophy (CRPS I): mechanisms and diagnostic value.
It is suggested that, in CRPS I, unilateral inhibition of sympathetic vasoconstrictor neurones leads to a warmer affected limb in the acute stage, whereas sympathetic activity is still depressed.
The Prevalence of Fibromyalgia in Other Chronic Pain Conditions
  • M. Yunus
  • Medicine
    Pain research and treatment
  • 2012
Diagnosis and proper management of FMS among these diseases are of crucial importance so that unwarranted use of such medications as corticosteroids can be avoided, since FMS often occurs when RA or SLE is relatively mild.