Efficacy and Effectiveness of Physical Agent Modalities in Complex Regional Pain Syndrome Type I: A Scoping Review

Moretti, Antimo; Gimigliano, Francesca; Paoletta, Marco; Liguori, Sara; Toro, Giuseppe; Aulicino, Milena; Conversano, Stefano; Iolascon, Giovanni

doi:10.3390/app11041857

Cited by 11 publications

(10 citation statements)

References 35 publications

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“…In addition, Jong Ho Choi et al [39] verified that higher HbA1c could be related to higher CRPS prevalence and that uncontrolled blood glucose could increase CRPS occurrence. Among the treatment of CRPS, it has always been a controversial issue whether physical therapy has a role for improving the clinical condition [40]. Diabetes mellitus was the risk factor of CRPS I.…”

Section: Discussionmentioning

confidence: 99%

Determinants of complex regional pain syndrome type I in patients with scaphoid waist fracture- a multicenter prospective observational study

Gong

Zhao

Liu

et al. 2022

BMC Musculoskelet Disord

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Background The aim of this prospective study was to assess the incidence of complex regional pain syndrome type I (CRPS I) in patients with scaphoid waist fracture and to explore associated factors. Methods This was a multicenter, prospective observational study. Demographic, imaging indicators and clinical data were collected before the conservative treatment of scaphoid waist fracture patients. The occurrence of CRPS I and pain condition were the main outcomes. To explore the factors associated with CRPS I, multivariate logistic regression model was used. Results A total of 493 scaphoid waist fracture participants undergoing conservative treatment were recruited for this study. The incidence of CRPS I was 20% (n = 87). The average time between injury and the onset of CRPS I was 6.7 ± 2.1 weeks. Multivariable logistic regression analysis revealed that female sex (odds ratio (OR): 1.669; 95% confidence interval (CI): 1.189–2.338), diabetes mellitus (OR: 3.206; 95% CI: 2.284–4.492), and severe pain condition before treatment (visual analog scale (VAS) score more than 4 cm) (OR: 27.966; 95% CI: 19.924–39.187) were independently associated with CRPS I. Conclusions Patients suffering from scaphoid waist fracture may be at a higher risk of CRPS I, especially in women with diabetes mellitus who report severe pain before treatment. Early screening and regular follow up evaluation are recommended in these patients.

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Section: Discussionmentioning

confidence: 99%

Determinants of complex regional pain syndrome type I in patients with scaphoid waist fracture- a multicenter prospective observational study

Gong

Zhao

Liu

et al. 2022

BMC Musculoskelet Disord

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“…In our tertiary referral centre, all CRPS patients are advised to start active physiotherapy. Physiotherapy, physical rehabilitation and physical agent modalities can result in pain relief and better function in CRPS patients [ 11 , 82 , 208 ]. Medication can be prescribed in addition to active physiotherapy.…”

Section: Expert Opinionmentioning

confidence: 99%

From a Symptom-Based to a Mechanism-Based Pharmacotherapeutic Treatment in Complex Regional Pain Syndrome

Mangnus

Bharwani

Dirckx

et al. 2022

Drugs

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Complex regional pain syndrome (CRPS) is a debilitating painful condition of a distal extremity that can develop after tissue damage. CRPS is thought to be a multimechanism syndrome and ideally the most prominent mechanism(s) should be targeted by drugs in an individually tailored manner. This review gives an overview of the action and evidence of current and future pharmacotherapeutic options for CRPS. The available options are grouped in four categories by their therapeutic actions on the CRPS mechanisms, i.e. inflammation, central sensitisation, vasomotor disturbances and motor disturbances. More knowledge about the underlying mechanisms of CRPS helps to specifically target important CRPS mechanisms. In the future, objective biomarkers could potentially aid in selecting appropriate mechanism-based drugs in order to increase the effectiveness of CRPS treatment. Using this approach, current and future pharmacotherapeutic options for CRPS should be studied in multicentre trials to prove their efficacy. The ultimate goal is to shift the symptom-based selection of therapy into a mechanism-based selection of therapy in CRPS.

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“…Physical modalities, in particular electrotherapy (such as TENS) and pulsed electromagnetic field therapy, may help to reduce pain and improve function when combined with other interventions for CRPS type I, even though high-quality evidence is not available and a standardized treatment protocol has not yet been defined [27] . Moreover, psychological therapies, such as cognitive-behavioral therapy, operant conditioning, counseling, pain education and relaxation techniques, can be used for educating the patient, thus improving function and disability [28] .…”

Section: Treatment Optionsmentioning

confidence: 99%

Post-traumatic and non-traumatic Complex Regional Pain Syndrome type I

et al. 2022

Self Cite

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Complex regional pain syndrome (CRPS) is an umbrella term covering different clinical scenarios. It is a rare condition characterized by regional persisting pain, disproportionate to its underlying cause, usually coupled with sensorimotor, vasomotor, sudomotor, and trophic abnormalities. Different forms of CRPS have been identified: CRPS type I (algodystrophy); CRPS type II (causalgia); CRPS-NOS (not otherwise specified), and CRPS with remission of some features (CRSF). The pathophysiology of algodystrophy is probably related to multiple mechanisms, such as abnormal inflammation, vasomotor dysfunction, and maladaptive neuroplasticity. In most cases this condition is related to traumatic injuries or fractures, most frequently located at the distal upper limb, although in some patients no related triggering factor can be found. Algodystrophy occurrence after non-orthopedic surgery or procedures, such as percutaneous transluminal coronary angioplasty, cardiac ablation, hemodialysis, or transplantation, is rare and underestimated. Imaging can assist clinicians in the very challenging differential diagnosis of CRPS. To prevent severe and disabling consequences, international guidelines suggest a prompt multimodal approach to algodystrophy, including pharmacological (bisphosphonates, particularly neridronate) and non-pharmacological (i.e., rehabilitation interventions) measures.

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Efficacy and Effectiveness of Physical Agent Modalities in Complex Regional Pain Syndrome Type I: A Scoping Review

Cited by 11 publications

References 35 publications

Determinants of complex regional pain syndrome type I in patients with scaphoid waist fracture- a multicenter prospective observational study

Determinants of complex regional pain syndrome type I in patients with scaphoid waist fracture- a multicenter prospective observational study

From a Symptom-Based to a Mechanism-Based Pharmacotherapeutic Treatment in Complex Regional Pain Syndrome

Post-traumatic and non-traumatic Complex Regional Pain Syndrome type I

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