Complex Regional Pain Syndrome

  • René F. Rodríguez Anestesiólogo, docente Universidad Libre Cali. Clínica del Dolor y Cuidados Paliativos de la Clínica Rafael Uribe Uribe. Grupo Investigación CADPAL. Cali, Colombia.
  • Ana María Ángel Isaza Universidad Libre Cali. Grupo Investigación Clínica para el Alivio del Dolor y Cuidados Paliativos CADPAL. Cali, Colombia
Keywords: Complex Regional Pain Syndrome, pain, Causalgia, Peripheral Nerves, Hyperalgesia

Abstract

Introduction. Complex Regional Pain Syndrome (CRPS) is a chronic disabling disorder that occurs after an injury. Pain, changes in the color and temperature of the skin, edema and trophic changes are the main characteristics of this syndrome.

Objective. To provide a current literature overview of the CRPS to improve its understanding.

Methodology. An extensive literature search both in indexed journals and pain medicine books was performed. Forty eight articles and 4 book chapters about pain medicine were included.

Conclusion. CRPS is difficult to manage and if it is not treated adequately, functionality of the affected limb can be compromised. Early diagnosis and treatment may reduce the severity and duration of this condition.

References

1. Wilsey B, Teicheira D, Caneris OA, Fishman SM. A review of sympathetically maintained pain syndromes in the cancer pain population. Pain practice 2001;1:307-23.
2. Mitchell SW, Morehouse GR, Keen WW. Gunshot wounds and other injuries of nerves. Philadelphia: JB Lippincott, 1864, 100-11. (Reprinted in Clin Orthop Relat Res, 1982;163:2-7).
3. Schott GD. Complex? Regional? Pain? Syndrome? Pract Neurol 2007;7:145-57.
4. Díaz PA, Plancarte R, Tamayo AC. Síndrome doloroso regional complejo. Estado actual. Cir Ciruj 2004;72:225-38.
5. Merskey H, Bogduk N. Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms. Second edition. Seattle, Washington: IASP Press;1994:40-2.
6. Cepeda S. Síndrome doloroso regional complejo tipos I-II. En: Rodríguez RF. Medicina del dolor y cuidados paliativos. Cali: Editorial Universidad Libre; 1998; 71-79.
7. Bruehl S, Harden RN, Galer BS, Saltz S, Bertram M, Backonja M, Gayles R, Rudin N, Bhugra MK, Stan-ton-Hicks M: External validation of IASP diagnostic criteria for complex regional pain syndrome and proposed research diagnostic criteria. Pain 1999; 81:147-54
8. Veldman PH, Reynen HM, Arntz IE, Goris RJ. Signs and symptoms of reflex sympathetic dystrophy: prospective study of 829 patients. Lan-cet.1993;342:1012-6.
9. Raja SN, Grabow TS. Complex Regional Pain Syndrome I (Reflex Sympathetic Dystrophy). Anesthesi-ology.2002; 96:1254-60.
10. Ribera MV. Síndrome de dolor regional complejo tipo I y II. Dolor. 2003;18:83-84.
11. Neira F, Ortega J. L. El síndrome doloroso regional complejo y medicina basada en la evidencia. Rev. Soc. Esp. Dolor 2007;2:133-46.
12. Gler BS, Scwartz L, Allen R. Síndromes de dolor regional complejo: tipo I (distrofia simpática refleja) y tipo II (causalgia). En: Loeser JD, Butler SH, Chapman CR, et al. Bonica Terapéutica del Dolor. Vol I. 3a ed., México: McGraw-Hill Interamericana; 2003. p. 467-96.
13. Matoses MS. Síndrome del dolor regional complejo. Dolor neuropático periférico. Dolor. 2002;17:78-86.
14. Obata FC, Tsa LL. Síndrome dolorosa complexa regional: Epidemiologia, fisiopatologia, manifestações clínicas, testes diagnósticos e propostas terapêuticas. Rev Bras Anestesiol.2002;52:5:618-27
15. De Mos M, de Bruijn AGJ, Huygen FJPM, Dieleman JP, Stricker BHCh, Sturkenboom MCJM. The incidence of complex regional pain syndrome: A population-based study. Pain.2007;129:12-20.
16. Sandroni P, Benrud-Larson LM, McClelland RL, Low PA. Complex regional pain syndrome type I: incidence and prevalence in Olmsted county, a population-based study. Pain.2003;103:199-207.
17. Pertoldi S, Di Benedetto P. Shoulder-hand syndrome after stroke. A complex regional pain syndrome. Eura Medicophys. 2005;41:283-92.
18. Kiralp ZM, Dinger Ü, Çakar E, Dursun H. Complex regional pain syndrome: epidemiologic features, treatment approaches, workday loss and return to work/disability ratios. Turk J Rheumatol 2009;24:1-5.
19. Rodríguez RF, Angel AM. Epidemiology and clinical characteristics of complex regional pain syndrome of upper limb in Valle-Colombia. In press
20. Janig W, Baron R. Complex regional pain syndrome: mystery explained? Lancet Neurol. 2003;2:687-97.
21. Ghai B, Dureja GP. Complex regional pain syndrome: A review. J Postgrad Med. 2004;50:300-7.
22. Schurmann M, Gradl G, Zaspel J, Kayser M, Lohr P, Andress HJ. Peripheral sympathetic function as a predictor of complex regional pain syndrome type I in patients with radial fracture. Auton Neuros-ci.2000;86:127-34.
23. Drummond DP. Involvement of the Sympathetic Nervous System in Complex Regional Pain Syndrome. Neurology. 2001;9:1296-303.
24. Wasner G, Heckmann K, Maier C, Baron R. Vascular abnormalities in acute reflex sympathetic dystrophy (CRPS I): complete inhibition of sympathetic nerve activity with recovery. Arch Neurol. 1999;56:613-20.
25. Garrido B. Complex regional pain syndrome. An approach between physiopathology and therapeutics. Rev Soc Esp Dolor. 2005;12:227-34.
26. Rommel O, Gehling M, Dertwinkel R, Witscher K, Zenz M, Malin JP, Janig, W. Hemisensory impairment in patients with complex regional pain syndrome. Pain 1999;80:95-101.
27. Rommel O, Thimineur M. Clinical evidence of central sensory disturbances in CRPS. En: Harden RN, Baron R, Janing W, editors. Complex regional pain syndrome. Vol 22.Seattle: IASP Press; 2001;193-208.
28. Sieweki N, Birklein F, Riedl B, Neundorfer B, Handwerker HO. Patterns of hiperalgesia in complex regional pain sindrome. Pain.1999;80:171-7.
29. Weber M, Birklein, B. Neundörfer, M. Schmelz. Facilitated neurogenic inflammation in complex regional pain syndrome. Pain.2001;91(3):251-7.
30. Üceyler N, Eberle T, Rolke R, Birklein F Sommer C. Differential expression patterns of cytokines in complex regional pain syndrome. Pain.2007;132: 195-205. 31. Blumberg H, Janing W. Clinical manifestation of reflex sympathetic dystrophy and sympathetically maintained pain. In: Wall PD, Melzack R (eds). Textbook of pain, 3rd ed. Edinburg: Churchill Livingstone; 1994. p. 685-98.
32. Birklein F, Riedl B, Neundorfer B, Handwerker HO. Sympathetic vasoconstrictor reflex pattern in patients with complex regional pain syndrome. Pain.1998;75:93-100.
33. Wasner G, Heckmann K, Maier C, Baron R. Vascular abnormalities in acute reflex sympathetic dystrophy (CRPS I): Complete inhibition of sympathetic nerve activity with recovery. Arch Neurol. 1999;56:613-20.
34. Allen G, Galer BS, Schwartz L. Epidemiology of complex regional pain syndrome: a retrospective chart review of 134 patients. Pain.1999;80:539-44.
35. Rashiq, S., Galer, B.S. Proximal myofascial dysfunction in complex regional pain syndrome: a retrospective prevalence study. Clin J Pain. 1999;15:151-3.
36. Galer BS, Henderson J, Perander J, Jensen MP. Course of symptoms and quality of life measurement in complex regional pain syndrome: a pilot survey. J Pain Symptom Manage. 2000;20:286-92.
37. Rowbotham MC. Pharmacological management of complex regional pain syndrome. Clin J Pain. 2006;22:425-9.
38. Van de Vusse AC, Stomp van den Berg SG, Kessels AH, Weber WE. Randomised controlled trial of gabapentin in Complex Regional Pain Syndrome type I. BMC Neurology.2004;4:13-22.
39. Sindrup SH, Andersen G, Madsen C, Smith T, Brosen K, Jensen TS. Tramadol relieves pain and allodynia in polyneuropathy: a randomised, double-blind, controlled trial. Pain.1999;83:85-90.
40. Harati Y, Gooch C, Swenson M, et al. Doubleblind randomized trial of tramadol for the treatment of the pain of diabetic neuropathy. Neurol-ogy.1998;50:1842-6.
41. Varenna M, Zucchi F, Ghiringhelli D, Binelli L, Bevi-lacgua M, Bettica P, Sinigaglia L. Intravenous clo-dronate in the treatment of reflex sympathetic dystrophy syndrome. A randomized, double blind, placebo controlled study. J Rheumatol. 2000;27:1477-83.
42. Adami S, Fossaluzza V, Gatti D, Fracassi, E; Braga, V. Bisphosphonate therapy of reflex sympathetic dystrophy syndrome. Ann Rheum Dis. 1997;56:201-4. [43. Cliffort J, Wolf, Mannion RJ. Dolor neuropático, etiología, mecanismos y manejo. Lancet. 1999;353:1959-64.
44. Gobelet C, Waldburger M, Meier JL. The effect of adding calcitonin to physical treatment on reflex sympathetic dystrophy. Pain.1992;48:171-5.
45. Bickerstaff DR, Kanis JA. The use of nasal calcitonin in the treatment of post-traumatic algodystrophy. Br J Rheumatol.1991;30:291-4.
46. Stanton-Hicks M. Complex regional pain syndrome (type-I, RSD; type-II, causalgia): controversies. Clin J Pain. 2000;16:33-40.
47. Kidd BL, Urbán LA. Mecanismos del dolor inflamatorio. British Journal of Anaesthesia.2001;87:3-11.
48. Braus DF, Kraus JK, Strobel J. The shoulder hand syndrome after stroke: a prospective clinical trial. Ann Neurol. 1994;36:728-33.
49. Christensen K, Jensen EM, Noer I. The reflex sympathetic dystrophy syndrome response to treatment with systemic corticosteroids. Acta Chir Scand. 1982;148:653-5.
50. Kemler MA, Barendse GA, van Kleef M, de Vet HC, Rijks CP, Furnee CA, van den Wildenberg FA. Spinal cord stimulation in patients with chronic reflex sympathetic dystrophy. N Engl J Med. 2000;343: 618-24.
51. Galer BS, Butler S, Jensen MP. Case reports and hypothesis: a neglect-like syndrome may be responsible for the motor disturbance in reflex sympathetic dystrophy (CRPS 1). J Pain Symptom Manage. 1995;10:385-91.
52. Hareau J. What makes treatment of reflex sympathetic dystrophy successful? J Hand Ther.1996;9:367-70.
How to Cite
1.
Rodríguez RF, Ángel Isaza AM. Complex Regional Pain Syndrome. Colomb. J. Anesthesiol. [Internet]. 2011Jan.1 [cited 2021Sep.27];39(1):71-3. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/717

Downloads

Download data is not yet available.
Published
2011-01-01
How to Cite
1.
Rodríguez RF, Ángel Isaza AM. Complex Regional Pain Syndrome. Colomb. J. Anesthesiol. [Internet]. 2011Jan.1 [cited 2021Sep.27];39(1):71-3. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/717
Section
Narrative review

More on this topic