The Outcome of Complex Regional Pain Syndrome Type 1: A Systematic Review

Bean, Debbie; Johnson, Malcolm H.; Kydd, Robert R.

doi:10.1016/j.jpain.2014.01.500

Cited by 112 publications

(97 citation statements)

References 39 publications

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“…Despite these difficulties, physiotherapy is recognised as an essential part in reducing pain and improving function in the management of CRPS [4, 8, 11, 47 -50]. Other data report favourable outcomes for a sub group of CRPS patients [25,38,51,52] which is consistent with this case series. However, it is reported that others recover poorly resulting in poor health and function [38, 45, 53 -55].…”

Section: Discussionsupporting

confidence: 84%

Physiotherapy Interventions and the Outcomes for Complex Regional Pain Syndrome (CRPS) Type 1 on the South Island of New Zealand – A Longitudinal, Prospective Case Series

Pons¹,

Shipton²,

Williman³

et al. 2017

TOPAINJ

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Physiotherapy is considered in pain medicine to be a key element in the management of Complex Regional Pain Syndrome (CRPS). This is the first paper to document and categorise all physiotherapy intervention methods used as well as evaluate the outcomes of a case series of 18 CRPS patients attending physiotherapy in a prospective, longitudinal study across a region. Outcomes were measured across the region of the South Island of New Zealand over 1 year through independent telephonic interviewing of the pain experience with the McGill Pain Questionnaire-short form, function with Foot Function Index for the lower limb or Disability of the Arm Shoulder and Hand for the upper limb, and quality of life with the World Health Organisation Disability Schedule. Clinical records were accessed for each CRPS participant following discharge from physiotherapy to categorise the intervention methods used. Seventeen participants received intervention for both functional restoration with pain modulation and only one participant received functional restoration with no pain modulation; 12 also received immobilisation with 10 receiving passive interventions. All outcome measures improved significantly by 6 months and were maintained at 1 year. Eighty five percent had their diagnosis of CRPS confirmed within 3 months of their injury; half had fracture as the precipitating injury for their onset of CRPS with a third following soft tissue injury and 11% following surgery. Physiotherapists showed a high variation with the intervention methods used and showed a greater proportion of intervention methods focusing on functional restoration followed by pain modulating interventions. Future research is necessary to define what physiotherapy interventions are efficacious in the management of CRPS.

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Section: Discussionsupporting

confidence: 84%

Physiotherapy Interventions and the Outcomes for Complex Regional Pain Syndrome (CRPS) Type 1 on the South Island of New Zealand – A Longitudinal, Prospective Case Series

Pons¹,

Shipton²,

Williman³

et al. 2017

TOPAINJ

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show abstract

“…90 Pain is a hallmark feature of this syndrome, and pain-related disability in the setting of CRPS is very common. Unfortunately, the mechanisms supporting these changes remain highly enigmatic, and available clinical treatments are limited in efficacy.…”

Section: Complex Regional Pain Syndromementioning

confidence: 99%

“…Unfortunately, the mechanisms supporting these changes remain highly enigmatic, and available clinical treatments are limited in efficacy. [90][91][92][93] A tibial fracture model was described that exhibits the principal…”

Section: Complex Regional Pain Syndromementioning

confidence: 99%

The inflammasome as a target for pain therapy

Zhang¹,

Li²,

Li³

et al. 2016

British Journal of Anaesthesia

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The interleukin-1 family of cytokines are potent inducers of inflammation and pain. Proteolytic activation of this family of cytokines is under the control of several innate immune receptors that coordinate to form large multiprotein signalling platforms, termed inflammasomes. Recent evidence suggests that a wide range of inflammatory diseases, cancers, and metabolic and autoimmune disorders, in which pain is a common complaint, may be coordinated by inflammasomes. Activation of inflammasomes results in cleavage of caspase-1, which subsequently induces downstream initiation of several potent pro-inflammatory cascades. Therefore, it has been proposed that targeting inflammasome activity may be a novel and effective therapeutic strategy for these pain-related diseases. The purpose of this narrative review article is to provide the reader with an overview of the activation and regulation of inflammasomes and to investigate the potential therapeutic role of inflammasome inhibition in the treatment of diseases characterized by pain, including the following: complex regional pain syndrome, gout, rheumatoid arthritis, inflammatory pain, neuropathic pain, chronic prostatitis, chronic pelvic pain syndrome, and fibromyalgia. We conclude that the role of the inflammasome in pain-associated diseases is likely to be inflammasome subtype and disease specific. The currently available evidence suggests that disease-specific targeting of the assembly and activity of the inflammasome complex may be a novel therapeutic opportunity for the treatment of refractory pain in many settings.

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“…This made comparison and interpretation of CRPS studies difficult. Varied standardized criteria were used to confirm CRPS diagnosis but not all were evidence-based (15,17). This has led to over diagnosis and often excessive pharmacotherapy (17).…”

Section: Resultsmentioning

confidence: 99%

“…Varied standardized criteria were used to confirm CRPS diagnosis but not all were evidence-based (15,17). This has led to over diagnosis and often excessive pharmacotherapy (17). Where conservative treatment proved unsuccessful in controlling pain symptoms SCS was considered.…”

Section: Resultsmentioning

confidence: 99%

Complex regional pain syndrome of the foot and its management using spinal cord stimulation

2017

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Objective: This article discusses neuropathic foot pain with particular reference to complex regional pain syndrome. It provides recommendations for the clinical evaluation of complex regional pain syndrome and highlights the value of spinal cord stimulation in its management. The aim is to review neuropathic foot pain in complex regional pain syndrome and outline its management using spinal cord stimulation. It is important for Podiatrists managing such patients to have an understanding of this treatment modality. Methods: A narrative literature review was undertaken using English language medical databases combining search strategies for complex regional pain syndrome and spinal cord stimulation. Results: Spinal cord stimulation improves the subjective symptoms of the neuropathic foot pain of complex regional pain syndrome, enables objective functional improvement and reduces analgesic consumption. Conclusion: Recent technical developments in spinal cord stimulation have led to improved stimulation patterns adapted to the patients' needs. Careful preoperative diagnosis, robust patient selection and frequent follow-up are vital for the success of this method.Key Words: complex regional pain syndrome; spinal cord stimulation; Neuralgia; foot; management. ResumenObjetivos: Este artículo describe el dolor neuropático de los pies con especial referencia al síndrome de dolor regional complejo. Proporciona recomendaciones para la evaluación clínica del síndrome de dolor regional complejo y pone de relieve el valor de la estimulación de la médula espinal en su gestión. El objetivo es revisar dolor en el pie neuropático en el síndrome de dolor regional complejo y resumen de su gestión mediante la estimulación de la médula espinal. Material y métodos: Una revisión de la literatura narrativa se llevó a cabo utilizando bases de datos médicas de idioma Inglés la combinación de estrategias de búsqueda para el síndrome de dolor regional complejo y estimulación de la médula espinal. Resultados: Estimulación de la médula espinal mejora los síntomas subjetivos del dolor neuropático pies del síndrome de dolor regional complejo, permite la mejora funcional objetivo y reduce el consumo de analgésicos. Conclusión: Los avances técnicos recientes en la estimulación de la médula espinal han dado lugar a patrones de estimulación mejoradas adaptaciones a las necesidades del paciente. diagnóstico preoperatorio cuidadosa, la selección de pacientes robusto y seguimiento frecuente son vitales para el éxito de este método. Es importante que los podólogos gestión de estos pacientes a tener una comprensión de esta modalidad de tratamiento.Palabras Clave: Síndrome de dolor regional complejo; estimulación de la médula espinal; neuralgia; pie; administración

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The Outcome of Complex Regional Pain Syndrome Type 1: A Systematic Review

Cited by 112 publications

References 39 publications

Physiotherapy Interventions and the Outcomes for Complex Regional Pain Syndrome (CRPS) Type 1 on the South Island of New Zealand – A Longitudinal, Prospective Case Series

Physiotherapy Interventions and the Outcomes for Complex Regional Pain Syndrome (CRPS) Type 1 on the South Island of New Zealand – A Longitudinal, Prospective Case Series

The inflammasome as a target for pain therapy

Complex regional pain syndrome of the foot and its management using spinal cord stimulation

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