Terminology, criteria, and definitions in complex regional pain syndrome: challenges and solutions

Dutton, Katherine; Littlejohn, Geoffrey

doi:10.2147/jpr.s53113

Cited by 17 publications

(12 citation statements)

References 38 publications

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“…Recent research would suggest that many chronic postoperative pain states are related to neural injury [62]. Complex regional pain syndrome, types I and II, the primary indication for DRG stimulation in the United States, has proven difficult to define and classify [63]. A poorly understood constellation of signs and symptoms, the initial journey of uncertainty surrounding nomenclature saw terms such as “angiospastic syndrome,” “algodystrophy,” and “shoulder-hand syndrome” come and go [64].…”

Section: Discussionmentioning

confidence: 99%

Neuromodulation of the Dorsal Root Ganglion for Chronic Postsurgical Pain

Antony

Schultheis

Jolly³

et al. 2019

Pain Medicine

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ObjectiveThe objective of this study is to review the available evidence for dorsal root ganglion (DRG) stimulation for the treatment of complex regional pain syndrome type II (CRPS II; peripheral causalgia) associated with chronic neuropathic postsurgical pain (NPP).DesignAvailable literature was identified through a search of the US National Library of Medicine’s Medline database, PubMed.gov. References from published articles also were reviewed for relevant citations.ResultsThe data published to date support the use of DRG stimulation to treat chronic NPP of the groin, knee, and foot. NPP following procedures such as thoracotomy, hernia surgery, and knee replacement surgery were identified as some of the conditions for which DRG stimulation is likely to be effective.ConclusionDRG stimulation is known to be an effective treatment for focal neuropathic pain. Currently, NPP of the foot, groin, and knee all appear to be the conditions with the most clinical experience, backed by a limited but growing body of evidence. However, prospective studies lag behind real-world clinical experience and are needed to confirm these findings.

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Section: Discussionmentioning

confidence: 99%

Neuromodulation of the Dorsal Root Ganglion for Chronic Postsurgical Pain

Antony

Schultheis

Jolly³

et al. 2019

Pain Medicine

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“…There are two types of CRPS based on aetiology: CRPS 1 in the absence of nerve damage and CRPS 2 (causalgia) 13 when associated with nerve damage. Veldman et al 4 and Hooshmand and Phillips 14 classified CRPS into various stages based on severity.…”

Section: Introductionmentioning

confidence: 99%

Quality of life after amputation in patients with advanced complex regional pain syndrome: a systematic review

et al. 2019

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The majority of included studies (8 out of 11, n = 54) supported the concept of considering amputation for selected, unresponsive cases of complex regional pain syndrome (CRPS) as a justifiable alternative to an unsuccessful multimodality nonoperative option. Of patients who underwent amputation, 66% experienced improvement in quality of life (QOL) and 37% were able to use a prosthesis, 16% had an obvious decline in QOL and for 12% of patients, no clear details were given, although it was suggested by authors that these patients also encountered deterioration after amputation. Complications of phantom limb pain, recurrence of CRPS and stump pain were predominant risks and were noticed in 65%, 45% and 30% of cases after amputation, respectively and two-thirds of patients were satisfied. Amputation can be considered by clinicians and patients as an option to improve QOL and to relieve agonizing, excruciating pain of severe, resistant CRPS at a specialized centre after multidisclipinary involvement but it must be acknowledged that evidence is limited, and the there are risks of aggravating or recurrence of CRPS, phantom pain and unpredictable consequences of rehabilitation. Amputation, if considered for resistant CRPS, should be carried out at specialist centres and after MDT involvement before and after surgery. It should only be considered if requested by patients with poor quality of life who have failed to improve after multiple treatment modalities. Further high quality and comprehensive research is needed to understand the severe form of CRPS which behaves differently form less severe stages. Cite this article: EFORT Open Rev 2019;4:533-540. DOI: 10.1302/2058-5241.4.190008

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“…[ 8 ] However, the distinction of CRPS types I and II based on the presence of a nerve injury has been disputed. [ 9 ] It is generally agreed that although the 2 types may be pathophysiologically different, the clinical symptoms remain the same. In a study of CRPS types I and II that were differentiated by a nerve conduction study, the frequency of clinical parameters was not different between the 2 types.…”

Section: Discussionmentioning

confidence: 99%

Complex regional pain syndrome type II after cervical transforaminal epidural injection

Park

Kwon²,

Kwon³

2018

Medicine

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Rationale:We report a case of a 61-year-old patient who developed complex regional pain syndrome (CRPS) type II after a cervical transforaminal epidural steroid injection (CTESI).Patient concerns:The patient developed sudden-onset severe pain and swelling of his upper right limb after a cervical transforaminal epidural injection.Diagnoses:On physical examination, the patient's symptoms and signs corresponded to the Budapest criteria for CRPS. Cervical magnetic resonance imaging and laboratory tests were performed to rule out other causes. An electrodiagnostic study revealed right C6/7 radiculopathies. A three-phase bone scan showed increased uptake in the right wrist in all phases. Thus, he was diagnosed with CRPS type II due to a cervical nerve root injury caused by the transforaminal epidural injection.Interventions:He received oral methylprednisolone and gabapentin, and underwent physical therapy for 9 days.Outcomes:The pain and swelling of his right upper limb disappeared and he returned to his previous functional activities.Lessons:CRPS type II due to cervical root injury is rare but can develop during CTESI. Early comprehensive physical therapy and oral medications might result in good outcomes.

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Terminology, criteria, and definitions in complex regional pain syndrome: challenges and solutions

Cited by 17 publications

References 38 publications

Neuromodulation of the Dorsal Root Ganglion for Chronic Postsurgical Pain

Neuromodulation of the Dorsal Root Ganglion for Chronic Postsurgical Pain

Quality of life after amputation in patients with advanced complex regional pain syndrome: a systematic review

Complex regional pain syndrome type II after cervical transforaminal epidural injection

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