Pain Control Techniques in Complex Regional Pain Syndrome.
PDF (Português (Brasil))

Keywords

Complex Regional Pain Syndrome, CRPS, pain management, pharmacological therapies, non-pharmacological therapies, electrical stimulation, pain management.

How to Cite

Ochoa Mora , E. Y., Chiriboga Quinto , J. E., Delgado Arias , C. J., Páez Valverde, C. A., & Cunache Baquerizo , R. A. (2024). Pain Control Techniques in Complex Regional Pain Syndrome. Brazilian Journal of Implantology and Health Sciences, 6(12), 140–157. https://doi.org/10.36557/2674-8169.2024v6n12p140-157

Abstract

Introduction: Complex Regional Pain Syndrome (CRPS) is a complex medical condition characterized by pain that is disproportionate to the initial injury. It is divided into CRPS-I (without detectable nerve damage) and CRPS-II (with peripheral nerve damage). Objective: To examine pain management techniques in CRPS, both pharmacological and non-pharmacological, evaluating their effectiveness in improving patients' quality of life. Methodology: A literature review was conducted using databases such as PubMed, Scopus, and Web of Science, focusing on peer-reviewed studies from the last ten years. Treatments were categorized into pharmacological treatments, nerve block techniques, physical and occupational therapies, psychological therapies, and electrical stimulation methods. Results: The incidence of CRPS varies between 5 and 26 per 100,000 people annually, with higher prevalence in postmenopausal women. NSAIDs and corticosteroids are commonly used but have limited effectiveness. Bisphosphonates and free radical scavengers have shown potential. Non-pharmacological therapies, such as physiotherapy and occupational therapy, in conjunction with electrical stimulation techniques like TENS, significantly improve functionality. Discussion: A multidisciplinary approach is crucial for managing CRPS. Pharmacological therapies offer limited relief and should be combined with physical and psychological treatments to maximize benefits. Cognitive-behavioral therapy and electrical stimulation techniques are promising. Conclusion: Managing CRPS requires a comprehensive and personalized approach. More clinical studies are needed to establish clear and effective guidelines, thereby improving clinical outcomes and the quality of life of patients.

https://doi.org/10.36557/2674-8169.2024v6n12p140-157
PDF (Português (Brasil))

References

Kim YD. Diagnosis of complex regional pain syndrome. Annals of Clinical Neurophysiology. 31 de octubre de 2022;24(2):35-45.

Mangnus TJ, Dirckx M, Huygen FJ. Different Types of Pain in Complex Regional Pain Syndrome Require a Personalized Treatment Strategy. JPR. 27 de diciembre de 2023;16:4379-91.

Iolascon G, de Sire A, Moretti A, Gimigliano F. Complex regional pain syndrome (CRPS) type I: historical perspective and critical issues. Clin Cases Miner Bone Metab. 2015;12(Suppl 1):4-10.

Ratti C, Nordio A, Resmini G, Murena L. Post-traumatic complex regional pain syndrome: clinical features and epidemiology. Clin Cases Miner Bone Metab. 2015;12(Suppl 1):11-6.

Savaş S, İnal EE, Yavuz DD, Uslusoy F, Altuntaş SH, Aydın MA. Risk factors for complex regional pain syndrome in patients with surgically treated traumatic injuries attending hand therapy. J Hand Ther. 2018;31(2):250-4.

Misidou C, Papagoras C. Complex Regional Pain Syndrome: An update. Mediterr J Rheumatol. 28 de marzo de 2019;30(1):16-25.

Taylor SS, Noor N, Urits I, Paladini A, Sadhu MS, Gibb C, et al. Complex Regional Pain Syndrome: A Comprehensive Review. Pain Ther. diciembre de 2021;10(2):875-92.

Diepold J, Deininger C, Von Amelunxen BC, Deluca A, Siegert P, Freude T, et al. Comparison of Epidemiological Data of Complex Regional Pain Syndrome (CRPS) Patients in Relation to Disease Severity—A Retrospective Single-Center Study. Int J Environ Res Public Health. 4 de enero de 2023;20(2):946.

Her YF, Kubrova E, Dombovy-Johnson M, ElSaban M, Mostert K, D’Souza RS. Complex Regional Pain Syndrome: Updates and Current Evidence. Curr Phys Med Rehabil Rep. 1 de marzo de 2024;12(1):50-70.

Resmini G, Ratti C, Canton G, Murena L, Moretti A, Iolascon G. Treatment of complex regional pain syndrome. Clin Cases Miner Bone Metab. 2015;12(Suppl 1):26-30.

Boichat C, Llewellyn A, Grieve S, McCabe C. The Role of Nonmedical Therapeutic Approaches in the Rehabilitation of Complex Regional Pain Syndrome. Curr Treat Options in Rheum. 1 de septiembre de 2020;6(3):299-311.

Alshehri FS. The complex regional pain syndrome: Diagnosis and management strategies. Neurosciences (Riyadh). octubre de 2023;28(4):211-9.

Elsharydah A, Loo NH, Minhajuddin A, Kandil ES. Complex regional pain syndrome type 1 predictors - Epidemiological perspective from a national database analysis. J Clin Anesth. junio de 2017;39:34-7.

Ott S, Maihöfner C. Signs and Symptoms in 1,043 Patients with Complex Regional Pain Syndrome. J Pain. junio de 2018;19(6):599-611.

Dey S, Guthmiller KB, Varacallo M. Complex Regional Pain Syndrome. En: StatPearls [Internet] [Internet]. StatPearls Publishing; 2023 [citado 9 de septiembre de 2024]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK430719/

Lipman MD, Hess DE, Werner BC, Deal DN. Fibromyalgia as a Predictor of Complex Regional Pain Syndrome After Distal Radius Fracture. Hand (N Y). julio de 2019;14(4):516-22.

Mangnus TJP, Bharwani KD, Dirckx M, Huygen FJPM. From a Symptom-Based to a Mechanism-Based Pharmacotherapeutic Treatment in Complex Regional Pain Syndrome. Drugs. 1 de abril de 2022;82(5):511-31.

Chevreau M, Romand X, Gaudin P, Juvin R, Baillet A. Bisphosphonates for treatment of Complex Regional Pain Syndrome type 1: A systematic literature review and meta-analysis of randomized controlled trials versus placebo. Joint Bone Spine. julio de 2017;84(4):393-9.

Tzschentke TM. Pharmacology of bisphosphonates in pain. Br J Pharmacol. mayo de 2021;178(9):1973-94.

Varenna M, Adami S, Sinigaglia L. Bisphosphonates in Complex Regional Pain syndrome type I: how do they work? Clin Exp Rheumatol. 2014;32(4):451-4.

Zuurmond WW, Langendijk PN, Bezemer PD, Brink HE, de Lange JJ, van loenen AC. Treatment of acute reflex sympathetic dystrophy with DMSO 50% in a fatty cream. Acta Anaesthesiol Scand. marzo de 1996;40(3):364-7.

Perez MRSG, Zuurmond AWW, Bezemer DP, Kuik JD, van Loenen CA, de Lange JJ, et al. The treatment of complex regional pain syndrome type I with free radical scavengers: a randomized controlled study. Pain. abril de 2003;102(3):297-307.

Dworkin RH, O’Connor AB, Backonja M, Farrar JT, Finnerup NB, Jensen TS, et al. Pharmacologic management of neuropathic pain: evidence-based recommendations. Pain. 5 de diciembre de 2007;132(3):237-51.

van de Vusse AC, Stomp-van den Berg SG, Kessels AH, Weber WE. Randomised controlled trial of gabapentin in Complex Regional Pain Syndrome type 1 [ISRCTN84121379]. BMC Neurology. 29 de septiembre de 2004;4(1):13.

Tan AK, Duman I, Taşkaynatan MA, Hazneci B, Kalyon TA. The effect of gabapentin in earlier stage of reflex sympathetic dystrophy. Clin Rheumatol. abril de 2007;26(4):561-5.

Brown S, Johnston B, Amaria K, Watkins J, Campbell F, Pehora C, et al. A randomized controlled trial of amitriptyline versus gabapentin for complex regional pain syndrome type I and neuropathic pain in children. Scand J Pain. octubre de 2016;13:156-63.

de la Calle JL, De Andres J, Pérez M, López V. Add-On Treatment with Pregabalin for Patients with Uncontrolled Neuropathic Pain Who Have Been Referred to Pain Clinics. Clin Drug Investig. 2014;34(12):833-44.

Lee SK, Yang DS, Lee JW, Choy WS. Four treatment strategies for complex regional pain syndrome type 1. Orthopedics. junio de 2012;35(6):e834-842.

Breuer AJ, Mainka T, Hansel N, Maier C, Krumova EK. Short-term treatment with parecoxib for complex regional pain syndrome: a randomized, placebo-controlled double-blind trial. Pain Physician. 2014;17(2):127-37.

Harden RN, Oaklander AL, Burton AW, Perez RSGM, Richardson K, Swan M, et al. Complex regional pain syndrome: practical diagnostic and treatment guidelines, 4th edition. Pain Med. febrero de 2013;14(2):180-229.

Goebel A, Birklein F, Brunner F, Clark JD, Gierthmühlen J, Harden N, et al. The Valencia consensus-based adaptation of the IASP complex regional pain syndrome diagnostic criteria. Pain. 1 de septiembre de 2021;162(9):2346-8.

Finch PM, Knudsen L, Drummond PD. Reduction of allodynia in patients with complex regional pain syndrome: A double-blind placebo-controlled trial of topical ketamine. Pain. noviembre de 2009;146(1-2):18-25.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright (c) 2024 Evelyn Yelena Ochoa Mora , Joel Elias Chiriboga Quinto , Carlos Jesús Delgado Arias , César Augusto Páez Valverde, Rafael Arnaldo Cunache Baquerizo

Downloads