Mechanism-specific rehabilitation management of complex regional pain syndrome: Proposed recommendations from evidence synthesis

Packham, Tara; Holly, Janet

doi:10.1016/j.jht.2018.01.007

Cited by 19 publications

(15 citation statements)

References 88 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Positive effects on the reported outcomes were obtained by treatment administration with different timings. Considering the huge variability in clinical scenarios and treatment response of patients with CRPS, the management of this condition should be based on a bio-psycho-social model [35] through a comprehensive assessment of impairments and activity limitations to guide multimodal interventions, including pharmacological and non-pharmacological treatments.…”

Section: Discussionmentioning

confidence: 99%

Complex Regional Pain Syndrome in Athletes: Scoping Review

et al. 2021

View full text Add to dashboard Cite

Background and Objectives: Complex regional pain syndrome (CRPS) is a chronic condition characterized by disproportionate regional pain, usually affecting distal limbs, that follows trauma or surgery. Athletes may develop CRPS because of exposure to traumatic or overuse injuries. The aim of the present study is to review the available literature about CRPS type 1 in athletes. Materials and Methods: We searched two online databases (PubMed and Web of Science), selecting papers aiming at investigating CRPS type 1 (algodystrophy) in athletes. The analysis of databases was made considering original articles published until 30 June 2021, written in English. Results: Fifteen papers (12 case reports, 3 case series) were selected for a total of 20 clinical cases (15 females, 5 males), aged between 10 and 46 years (mean age 18.4 ± 9.8 standard deviation years). Patients included practiced different types of sport (soccer, athletics, gymnastics, basketball). The most involved anatomical sites were lower limbs, and time to diagnosis ranged from 2 days to 4 years. The most used treatments were pharmacological and physical therapies, but sometimes invasive approaches, as regional nerve, or lumbar sympathetic blocks, were provided. The main assessed outcomes were return to activity and pain. Conclusions: Our review suggests a higher prevalence of CRPS type 1 in younger people and in lower limbs than in general population but confirms the higher prevalence in females. However, the number of studies addressing CRPS in athletes is limited, as well as the number of involved patients, considering that only few and heterogeneous case reports were published about this topic. Moreover, the high prevalence of old studies (only 5 available studies in the last 10 years) might have influenced the choice of both assessment tools and management strategies. Despite these limitations, athletes showing disproportionate pain after sport-related injury should be promptly evaluated and treated through a multidimensional approach to avoid long-term consequences of algodystrophy.

show abstract

Section: Discussionmentioning

confidence: 99%

Complex Regional Pain Syndrome in Athletes: Scoping Review

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Given the complexity of CRPS in many aspects, a multimodal approach is the most recommended by international guidelines, although there is considerable heterogeneity in the effectiveness of the treatments, which essentially depends on the variability in the quality of the evidence for pharmacological and non-pharmacological interventions [18] . In particular, Packman and colleagues provided practical instructions on how to operationalize the treatment and tailor it to the needs of individuals affected by algodystrophy [18] . They proposed a model for mechanism-tailored management of CPRS that may target more effectively the individual patient's unique needs and presentation of CRPS signs and symptoms (Fig.…”

Section: Treatment Optionsmentioning

confidence: 99%

“…Algodystrophy: what is the inciting event? [5,18] ) Int J Bone Frag. 2022; 2(1): [25][26][27][28][29] in sensory and motor processing aims to correct sensorimotor incongruence in afferent signaling from the affected limb [30,31] .…”

Section: Indeed Sequential Activation Of the Cortical Network Involvedmentioning

confidence: 99%

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

et al. 2022

View full text Add to dashboard Cite

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.

show abstract

“…A biopsychosocial model is deemed appropriate for understanding and treating CRPS [58]. However, more CRPS-specific research in this area is necessary especially high-quality randomized controlled trials on current treatment approaches [52,59].…”

Section: Psychological Therapymentioning

confidence: 99%

The Role of Nonmedical Therapeutic Approaches in the Rehabilitation of Complex Regional Pain Syndrome

Boichat

Llewellyn

Grieve

et al. 2020

Curr Treat Options in Rheum

View full text Add to dashboard Cite

Purpose of the Review Nonmedical therapeutic approaches are fundamental to the management of of Complex Regional Pain Syndrome (CRPS) in order to promote the best outcome for patients. This review focuses on three key approaches underpinning CRPS rehabilitation, namely, physiotherapy and occupational therapy, psychological approaches and education and self-management. Recent Findings Recently published European standards outline the quality of therapeutic care that people with CRPS must receive. Early initiated therapy is essential to optimise outcomes, underpinned by patient education. Therapists should promote early movement of the affected limb and encourage re-engagement with usual activities as immobilisation is known to have negative outcomes. There is evidence to support the possible long-term benefit of graded motor imagery and mirror therapy. Psychological assessment should include identification of depression and post-traumatic stress disorder, as treatment of * The Author(s) 2020 these conditions may improve the trajectory of CRPS. Novel therapies include neurocognitive approaches and those addressing spatial bias, both of which should provide a focus for future research. Summary There exists a broad range of nonmedical therapeutic approaches to rehabilitation for CPRS that are thought to be important. However, the evidence for their efficacy is limited. Further research using standardised outcomes would be helpful in developing targeted therapies for the future.

show abstract

Mechanism-specific rehabilitation management of complex regional pain syndrome: Proposed recommendations from evidence synthesis

Cited by 19 publications

References 88 publications

Complex Regional Pain Syndrome in Athletes: Scoping Review

Complex Regional Pain Syndrome in Athletes: Scoping Review

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

The Role of Nonmedical Therapeutic Approaches in the Rehabilitation of Complex Regional Pain Syndrome

Contact Info

Product

Resources

About