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The Need for Early Recognition of Complex Regional Pain Syndrome to Facilitate Early Effective Treatment (P7.318)
CONCLUSIONS: Early CRPS is more responsive to treatment than "established" CRPS. The diagnostic criteria of CRPS must be revised to aid in early CRPS recognition. Acknowledging allodynia, sensory manifestations and other features of the incomplete early CRPS spectrum can enhance efforts at resolving symptoms and improving function.Study Support: None.Disclosure: Dr. Laplant has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Laplant, J., Knobler, R. Tags: Pain and Palliative Care Source Type: research
Complex regional pain syndrome: yes, it’s complex
Complex regional pain sydrome or “CRPS” (pronounced CRIPS) is an enigma. It’s complex. It involves different body systems. It’s very, very painful, and it can be incredibly disabling. It has had lots of different names over the years – in 1982 when I trained it was called “causalgia” or “Sudeck’s atrophy”, but in 1993 the International Association for the Study of Pain developed guidelines for diagnosing and managing this complex pain problem.
Since then we’ve heard a lot about CRPS, at least those of us working in the pain management field have. I am not so...
Source: HealthSkills Weblog - July 6, 2014 Category: Occupational Therapists Authors: adiemusfree Tags: Chronic pain Pain conditions Research pain management Source Type: blogs
Characteristics of Complex Regional Pain Syndrome in Patients Referred to a Tertiary Pain Clinic by Community Physicians, Assessed by the Budapest Clinical Diagnostic Criteria
DiscussionBesides fulfilling the Budapest CRPS diagnostic criteria, the most important other factor for diagnosing CRPS is the exclusion of a neuropathic, musculoskeletal, or non‐biomedical condition accounting for the presentation.
Source: Pain Medicine - October 23, 2014 Category: Anesthesiology Authors: Angela Mailis‐Gagnon, Shehnaz Fatima Lakha, Matti D. Allen, Amol Deshpande, Robert Norman Harden Tags: Original Articles Source Type: research
The risk of pain syndrome affecting a previously non-painful limb following trauma or surgery in patients with a history of complex regional pain syndrome
Conclusions These result suggest that patients with a history of CRPS are more likely to develop secondary CRPS compared to the rates reported in the literature among the general population. Implications Patients with a history of CRPS should be counselled that they may be at risk for developing secondary CRPS if they undergo surgery or sustain trauma to another extremity.
Source: Scandinavian Journal of Pain - November 22, 2016 Category: Anesthesiology Source Type: research
Hemisensory disturbances in patients with complex regional pain syndrome
Sensory disturbances often spread beyond the site of injury in complex regional pain syndrome (CRPS) but whether this applies equally to CRPS I and II, or changes across the course of the disease, is unknown. Establishing this is important, because different symptom profiles in CRPS I and II, or in acute vs chronic CRPS, might infer different pathophysiology and treatment approaches. To explore these questions, sensory disturbances were assessed in the limbs and forehead of 71 patients with CRPS I and 33 patients with CRPS II. Pain had persisted up to 12 months in 32 patients, for 13 to 36 months in 29 patients, and for lo...
Source: Pain - August 23, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research
Validity of the Budapest Criteria For Poststroke Complex Regional Pain Syndrome
Discussion:
Our findings indicate that the diagnostic validity of the current Budapest clinical criteria for PS-CRPS is low. Thus, the current Budapest criteria might not be appropriate for PS-CRPS diagnosis.
Source: The Clinical Journal of Pain - September 4, 2019 Category: Anesthesiology Tags: Original Articles Source Type: research
Activation of Cutaneous Immune Responses in Complex Regional Pain Syndrome
Abstract: The pathogenesis of complex regional pain syndrome (CRPS) is unresolved, but tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6) are elevated in experimental skin blister fluid from CRPS-affected limbs, as is tryptase, a marker for mast cells. In the rat fracture model of CRPS, exaggerated sensory and sympathetic neural signaling stimulate keratinocyte and mast cell proliferation, causing the local production of high levels of inflammatory cytokines leading to pain behavior. The current investigation used CRPS patient skin biopsies to determine whether keratinocyte and mast cell proliferation occur in C...
Source: The Journal of Pain - January 24, 2014 Category: Materials Science Authors: Frank Birklein, Peter D. Drummond, Wenwu Li, Tanja Schlereth, Nahid Albrecht, Philip M. Finch, Linda F. Dawson, J. David Clark, Wade S. Kingery Tags: Original Reports Source Type: research
Injury Location and Mechanism for Complex Regional Pain Syndrome: A Nationwide Population‐Based Case–Control Study in Taiwan
ConclusionInjury in the extremities rather than the trunk is an important risk factor for CRPS. Certain injury mechanisms confer higher risk of CRPS. This nationwide study demonstrated that injury increased CRPS nearly threefold. Open wound, sprain and strain, superficial injury, contusion, and nerve and spinal cord injury are main injury mechanisms. Injury in the extremities confers a higher risk of CRPS.
Source: Pain Practice - May 7, 2014 Category: Anesthesiology Authors: Yi‐Chia Wang, Hung‐Yuan Li, Feng‐Sheng Lin, Ya‐Jung Cheng, Chi‐Hsiang Huang, Wei‐Han Chou, Hsing‐Hao Huang, Cheng‐Chieh Lin, Che‐Chen Lin, Fung‐Chang Sung, Jung‐Nan Wei Tags: Original Article Source Type: research
Complex regional pain syndrome: evidence for warm and cold subtypes in a large prospective clinical sample
This study for the first time used an unbiased statistical pattern recognition technique to evaluate whether distinct Warm vs Cold CRPS subtypes can be discerned in the clinical population. An international, multisite study was conducted using standardized procedures to evaluate signs and symptoms in 152 patients with clinical CRPS at baseline, with 3-month follow-up evaluations in 112 of these patients. Two-step cluster analysis using automated cluster selection identified a 2-cluster solution as optimal. Results revealed a Warm CRPS patient cluster characterized by a warm, red, edematous, and sweaty extremity and a Cold ...
Source: Pain - July 26, 2016 Category: Anesthesiology Tags: Research Paper Source Type: research
Complex regional pain syndrome: intradermal injection of phenylephrine evokes pain and hyperalgesia in a subgroup of patients with upregulated α1-adrenoceptors on dermal nerves
The aim of this study was to determine whether upregulated cutaneous expression of α1-adrenoceptors (α1-AR) is a source of pain in patients with complex regional pain syndrome (CRPS). Immunohistochemistry was used to identify α1-AR on nerve fibres and other targets in the affected and contralateral skin of 90 patients, and in skin samples from 38 pain-free controls. The distribution of α1-AR was compared between patients and controls, and among subgroups of patients defined by CRPS duration, limb temperature asymmetry, and diagnostic subtype (CRPS I vs CRPS II). In addition, α1-AR expression was investigated in relati...
Source: Pain - October 25, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research
Musculoskeletal changes on 18FFDG PET/MRI from complex regional pain syndrome in foot.
Conclusions: In this study, we investigated the feasibility of [18F]FDG PET/MRI to examine musculoskeletal changes by CRPS. Our results showed improved sensitivity of [18F]FDG PET/MRI over the conventional MRI examination. In most patients, focally increased metabolism was observed on the affected muscles without any MR abnormalities. It may suggest the sensitivity of [18F]FDG PET to early changes before the onset of irreversible muscle or skin atrophy. Also, the existence of global metabolic abnormalities may suggest that multiple CRPS subtypes with different etiologies could be responsible for similar clinical manifestat...
Source: Journal of Nuclear Medicine - May 20, 2019 Category: Nuclear Medicine Authors: Yoon, D., Xu, Y., Cipriano, P., Tawfik, V., Curtin, C., Carroll, I., Biswal, S. Tags: Musculoskeletal Source Type: research
Complex Regional Pain Syndrome: A Comprehensive Review
In conclusion, CRPS is a multifactorial condition that still requires further studying to better understand its pathogenesis, epidemiology, genetic involvement, psychological implications, and treatment options. Future studies are warranted to better understand this syndrome. This will provide an opportunity for better prevention, diagnosis, and treatment of CRPS.
Source: Pain and Therapy - June 24, 2021 Category: Anesthesiology Source Type: research
Osteoprotegerin: A new biomarker for impaired bone metabolism in complex regional pain syndrome?
Summary: We provide evidence that elevated serum osteoprotegerin reflects pathophysiological processes of complex regional pain syndrome.Abstract: Osteoprotegerin (OPG) is important for bone remodeling and may contribute to complex regional pain syndrome (CRPS) pathophysiology. We aimed to assess the value of OPG as a biomarker for CRPS and a possible correlation with radiotracer uptake in 3-phase bone scintigraphy (TPBS). OPG levels were analyzed in 23 CRPS patients (17 women; mean age 50±9.0years; disease duration: 12weeks [IQR 8–24]), 10 controls (6 women; mean age 58±9.6years) and 21 patients after uncomplicated fr...
Source: Pain - January 21, 2014 Category: Anesthesiology Authors: Heidrun H. Krämer, Lorenz C. Hofbauer, Gabor Szalay, Markus Breimhorst, Tatiana Eberle, Katja Zieschang, Martina Rauner, Tanja Schlereth, Matthias Schreckenberger, Frank Birklein Tags: Research papers Source Type: research
