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10. Complex regional pain syndrome.

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Title: 10. Complex regional pain syndrome.
Authors: van der Spek, Daniël P. C., Dirckx, Maaike, Mangnus, Thomas J. P., Cohen, Steven P., Huygen, Frank J. P. M.
Source: Pain Practice. Jan2025, Vol. 25 Issue 1, p1-16. 16p.
Subjects: Neuralgia, Baclofen, Diphosphonates, Ketamine, Spinal injections, Complex regional pain syndromes, Nociceptive pain, Intravenous therapy, Pain management, Electric stimulation, Evidence-based medicine, Sympatholytic agents
Abstract: Introduction: Complex regional pain syndrome (CRPS) is a clinical disorder that can develop following surgery or trauma. Based on the most prominent underlying pathophysiological mechanisms, CRPS can be classified into different subtypes, namely inflammatory, nociplastic/neuropathic, vasomotor, and motor. Depending on the subtype, personalized treatment can be applied. If conservative treatments are insufficient or ineffective, more invasive treatments may be recommended. This article provides an overview of the most recent insights into CRPS and discusses the most common invasive treatments. Methods: The literature regarding interventional treatments for CRPS has been systematically reviewed and summarized. Results: Bisphosphonates are effective in treating the inflammatory subtype, while ketamine can provide pain relief for the nociplastic/neuropathic subtype. Sympathetic blocks are effective in addressing vasomotor disturbances. For patients with refractory symptoms, neurostimulation is a viable option due to its multimechanistic properties for all subtypes. End‐of‐line motor disturbances may benefit from intrathecal baclofen. Conclusions: CRPS is a debilitating condition with an unpredictable course. The effectiveness of treatment varies from patient to patient. When conservative approaches prove insufficient, gradual progression to invasive treatments based on the underlying subtype is recommended. [ABSTRACT FROM AUTHOR]
Copyright of Pain Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: <searchLink fieldCode="DE" term="%22Neuralgia%22">Neuralgia</searchLink><br /><searchLink fieldCode="DE" term="%22Baclofen%22">Baclofen</searchLink><br /><searchLink fieldCode="DE" term="%22Diphosphonates%22">Diphosphonates</searchLink><br /><searchLink fieldCode="DE" term="%22Ketamine%22">Ketamine</searchLink><br /><searchLink fieldCode="DE" term="%22Spinal+injections%22">Spinal injections</searchLink><br /><searchLink fieldCode="DE" term="%22Complex+regional+pain+syndromes%22">Complex regional pain syndromes</searchLink><br /><searchLink fieldCode="DE" term="%22Nociceptive+pain%22">Nociceptive pain</searchLink><br /><searchLink fieldCode="DE" term="%22Intravenous+therapy%22">Intravenous therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Pain+management%22">Pain management</searchLink><br /><searchLink fieldCode="DE" term="%22Electric+stimulation%22">Electric stimulation</searchLink><br /><searchLink fieldCode="DE" term="%22Evidence-based+medicine%22">Evidence-based medicine</searchLink><br /><searchLink fieldCode="DE" term="%22Sympatholytic+agents%22">Sympatholytic agents</searchLink>
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  Data: Introduction: Complex regional pain syndrome (CRPS) is a clinical disorder that can develop following surgery or trauma. Based on the most prominent underlying pathophysiological mechanisms, CRPS can be classified into different subtypes, namely inflammatory, nociplastic/neuropathic, vasomotor, and motor. Depending on the subtype, personalized treatment can be applied. If conservative treatments are insufficient or ineffective, more invasive treatments may be recommended. This article provides an overview of the most recent insights into CRPS and discusses the most common invasive treatments. Methods: The literature regarding interventional treatments for CRPS has been systematically reviewed and summarized. Results: Bisphosphonates are effective in treating the inflammatory subtype, while ketamine can provide pain relief for the nociplastic/neuropathic subtype. Sympathetic blocks are effective in addressing vasomotor disturbances. For patients with refractory symptoms, neurostimulation is a viable option due to its multimechanistic properties for all subtypes. End‐of‐line motor disturbances may benefit from intrathecal baclofen. Conclusions: CRPS is a debilitating condition with an unpredictable course. The effectiveness of treatment varies from patient to patient. When conservative approaches prove insufficient, gradual progression to invasive treatments based on the underlying subtype is recommended. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Pain Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/papr.13413
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      – Code: eng
        Text: English
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        PageCount: 16
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      – SubjectFull: Neuralgia
        Type: general
      – SubjectFull: Baclofen
        Type: general
      – SubjectFull: Diphosphonates
        Type: general
      – SubjectFull: Ketamine
        Type: general
      – SubjectFull: Spinal injections
        Type: general
      – SubjectFull: Complex regional pain syndromes
        Type: general
      – SubjectFull: Nociceptive pain
        Type: general
      – SubjectFull: Intravenous therapy
        Type: general
      – SubjectFull: Pain management
        Type: general
      – SubjectFull: Electric stimulation
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      – SubjectFull: Evidence-based medicine
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      – SubjectFull: Sympatholytic agents
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      – TitleFull: 10. Complex regional pain syndrome.
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            NameFull: van der Spek, Daniël P. C.
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            NameFull: Dirckx, Maaike
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            – D: 01
              M: 01
              Text: Jan2025
              Type: published
              Y: 2025
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