Extent of recovery in the first 12 months of complex regional pain syndrome type‐1: A prospective study

Bean, Debbie; Johnson, Malcolm H.; Heiss-Dunlop, Wolfgang; Kydd, Robert R.

doi:10.1002/ejp.813

Cited by 79 publications

(91 citation statements)

References 32 publications

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“…6 Even with this improvement, however, the majority (∼75%) continue to meet the commonly used Budapest criteria for diagnosis. 7 Over 80% of chronic CRPS patients are severely disabled. 8 Treatment strategies are most often symptomatic and focus on rehabilitation; no currently available treatment is disease modifying.…”

Section: Introductionmentioning

confidence: 99%

Autoinflammatory and autoimmune contributions to complex regional pain syndrome

et al. 2018

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Complex regional pain syndrome (CRPS) is a highly enigmatic syndrome typically developing after injury or surgery to a limb. Severe pain and disability are common among those with chronic forms of this condition. Accumulating evidence suggests that CRPS may involve both autoinflammatory and autoimmune components. In this review article, evidence for dysfunction of both the innate and adaptive immune systems in CRPS is presented. Findings from human studies in which cytokines and other inflammatory mediators were measured in the skin of affected limbs are discussed. Additional results from studies of mediator levels in animal models are evaluated in this context. Similarly, the evidence from human, animal, and translational studies of the production of autoantibodies and the potential targets of those antibodies is reviewed. Compelling evidence of autoinflammation in skin and muscle of the affected limb has been collected from CRPS patients and laboratory animals. Cytokines including IL-1β, IL-6, TNFα, and others are reliably identified during the acute phases of the syndrome. More recently, autoimmune contributions have been suggested by the discovery of self-directed pain-promoting IgG and IgM antibodies in CRPS patients and model animals. Both the autoimmune and the autoinflammatory components of CRPS appear to be regulated by neuropeptide-containing peripheral nerve fibers and the sympathetic nervous system. While CRPS displays a complex neuroimmunological pathogenesis, therapeutic interventions could be designed targeting autoinflammation, autoimmunity, or the neural support for these phenomena.

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Section: Introductionmentioning

confidence: 99%

Autoinflammatory and autoimmune contributions to complex regional pain syndrome

et al. 2018

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“…La durée d'évolution est variable et non prévisible. Au-delà d'un an d'évolution, la persistance de douleurs et de limitations fonctionnelles semble fréquente (20 à 30 % des patients) [13]. On retrouve comme facteur de risque des SDRC les fractures, la douleur sous plâtre ou la douleur persistante après une fracture, y compris postopératoire.…”

Section: Diagnostic Cliniqueunclassified

Recommandations diagnostiques et de prise en charge thérapeutique des syndromes douloureux régionaux complexes : les recommandations de Lille

Sfetd¹

2019

Douleur analg

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La Société française d'étude et de traitement de la douleur présente les recommandations de diagnostic et de prise en charge des syndromes douloureux régionaux complexes. Ces recommandations ont été élaborées par des experts hospitaliers et libéraux (rhumatologue, neurologue, anesthésiste, chirurgien orthopédique, médecin nucléaire, algologue, médecin généraliste, psychologue, infirmière, IAD, kinésithérapeute) et un représentant d'association de patients. Une analyse systématique de la littérature a été réalisée. Vingt-six recommandations sont proposées. Elles mettent en avant l'utilisation des critères de Budapest pour le diagnostic clinique, la prise en charge réadaptative proposée systématiquement et précocement avec pour objectif le maintien ou la restauration de la mobilité articulaire. Les antalgiques, les antihyperalgésiants ou les bisphosphonates, en fonction des signes cliniques, peuvent être associés à une prise en charge réadaptative. La prévention des effets secondaires de ces traitements, du risque d'addiction doit être effective. Le recours aux techniques de neurostimulation peut être indiqué au sein d'une prise en charge pluridisciplinaire. Une prise en charge psychologique est recommandée quand il existe des facteurs psychologiques ou de vulnérabilité intervenant. AbstractThe Société française d'étude et de traitement de la douleur (French Society for the Study and Treatment of Pain) presents diagnostic and treatment recommendations for Complex Regional Pain Syndromes (CRPS). These recommendations were produced by hospital and private practice doctors (a rheumatologist, neurologist, anesthetist, orthopedic surgeon, nuclear medicine specialist, pain medicine specialist, general practitioner, psychologist, nurse, IAD, physiotherapist) and a representative from the patients' association. A systematic analysis of the literature was carried out. 26 recommendations are put forward. They showcase the use of the Budapest clinical diagnostic criteria, systematically offering early rehabilitative management with the aim of maintaining or restoring joint mobility. Depending on the clinical signs, analgesics, anti-hyperalgesic drugs or bisphosphonates may be used in association with rehabilitative management. Prevention of these treatments' side effects and the risk of addiction must be effective. Application of neurostimulation Recommandations diagnostiques et de prise en charge thérapeutique des syndromes douloureux régionaux complexes : les recommandations de Lille

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“…Most patients will improve over time (de Mos et al, 2009;Zyluk, 1998), although appropriate management very likely hastens recovery (Gillespie, Cowell, Cheung, & Brown, 2016). However, full recovery is less common, and many patients will be left with varying degrees of persistent pain and functional impairment (Bean, Johnson, Heiss-Dunlop, & Kydd, 2016). For some people, CRPS may become a long-lasting, highly disabling and distressing chronic pain condition.…”

Section: Introductionmentioning

confidence: 99%

Standards for the diagnosis and management of complex regional pain syndrome: Results of a European Pain Federation task force

Göebel

Barker

Birklein

et al. 2019

European Journal of Pain

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Background Complex regional pain syndrome is a painful and disabling post‐traumatic primary pain disorder. Acute and chronic complex regional pain syndrome (CRPS) are major clinical challenges. In Europe, progress is hampered by significant heterogeneity in clinical practice. We sought to establish standards for the diagnosis and management of CRPS. Methods The European Pain Federation established a pan‐European task force of experts in CRPS who followed a four‐stage consensus challenge process to produce mandatory quality standards worded as grammatically imperative (must‐do) statements. Results We developed 17 standards in 8 areas of care. There are 2 standards in diagnosis, 1 in multidisciplinary care, 1 in assessment, 3 for care pathways, 1 in information and education, 4 in pain management, 3 in physical rehabilitation and 2 on distress management. The standards are presented and summarized, and their generation and consequences were discussed. Also presented are domains of practice for which no agreement on a standard could be reached. Areas of research needed to improve the validity and uptake of these standards are discussed. Conclusion The European Pain Federation task force present 17 standards of the diagnosis and management of CRPS for use in Europe. These are considered achievable for most countries and aspirational for a minority of countries depending on their healthcare resource and structures. Significance This position statement summarizes expert opinion on acceptable standards for CRPS care in Europe.

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Extent of recovery in the first 12 months of complex regional pain syndrome type‐1: A prospective study

Cited by 79 publications

References 32 publications

Autoinflammatory and autoimmune contributions to complex regional pain syndrome

Autoinflammatory and autoimmune contributions to complex regional pain syndrome

Recommandations diagnostiques et de prise en charge thérapeutique des syndromes douloureux régionaux complexes : les recommandations de Lille

Standards for the diagnosis and management of complex regional pain syndrome: Results of a European Pain Federation task force

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