Search results for "Regional pain syndrome"

Chapter 35 Complex regional pain syndrome

2006

Publisher Summary This chapter describes complex regional pain syndrome (CRPS) as changes of muscles and bones distant from the primary tissue damage. It causes both acute pain and excitation of the sympathetic nervous system. The chapter classifies CRPS into two clinical types: the “primarily warm” type, which usually develops post-traumatically and in which skin temperature is increased on the affected side; and CRPS cases, which manifest with a cold skin from the beginning. This “primarily cold” type more often develops after minor trauma or even spontaneously. The chapter reviews that “primary cold” CRPS is harder to treat and tends to become chronic. Symptoms of CRPS are not stable; th…

Complex regional pain syndrome - phenotypic characteristics and potential biomarkers

2018

Complex regional pain syndrome (CRPS) is a pain condition that usually affects a single limb, often following an injury. The underlying pathophysiology seems to be complex and probably varies between patients. Clinical diagnosis is based on internationally agreed-upon criteria, which consider the reported symptoms, presence of signs and exclusion of alternative causes. Research into CRPS biomarkers to support patient stratification and improve diagnostic certainty is an important scientific focus, and recent progress in this area provides an opportunity for an up-to-date topical review of measurable disease-predictive, diagnostic and prognostic parameters. Clinical and biochemical attribute…

Standards for the diagnosis and management of complex regional pain syndrome: Results of a European Pain Federation task force.

2019

Background: Complex regional pain syndrome is a painful and disabling post-traumatic primary pain disorder. Acute and chronic complex regional pain syndrome (CRPS) are major clinical challenges. In Europe, progress is hampered by significant heterogeneity in clinical practice. We sought to establish standards for the diagnosis and management of CRPS. Methods: The European Pain Federation established a pan-European task force of experts in CRPS who followed a four-stage consensus challenge process to produce mandatory quality standards worded as grammatically imperative (must-do) statements. Results: We developed 17 standards in 8 areas of care. There are 2 standards in diagnosis, 1 in multi…

Perioperative management of patients with suspected or severe infection with SARS-CoV-2 coronavirus programmed for the implementation of electronic d…

2020

At the end of 2019, a series of patients affected by lung infection of initially unknown aetiology with clinical presentations very similar to viral pneumonia were registered in China. Sequencing analysis of samples from the lower respiratory tract identified a new type of virus from the family Coronaviridae called SARS-CoV-2 as the causative agent of the outbreak; the agent responsible for the disease that was renamed COVID-19.1 Since then, millions of cases have been identified around the world. The World Health Organization (WHO) initially declared the infection to be a Public Health Emergency of International Concern, and later classed it as a pandemic.2, 3 The vast majority of coronavi…

Lumbar and thoracic sympathetic radiofrequency lesioning in complex regional pain syndrome.

2006

Reduced serum protease activity in Complex Regional Pain Syndrome: The impact of angiotensin-converting enzyme and carboxypeptidases.

2021

Complex Regional Pain Syndrome (CRPS) occurs in about 2% of patients after fracture of the limbs. In an earlier clinical study with 102 probands we have shown that the serum protease network in CRPS might be less effective. Based on these results we hypothesized that angiotensin-converting enzyme (ACE) and carboxypeptidase N (CPN) activity contribute to the differences of labeled bradykinin (DBK) degradation by patients' sera. Details of the enzymatic processes remained however unclear. The contributions of ACE and CPN in the serum degradation of DBK were studied using specific inhibitors. CPN1-ELISA was performed in serum. It was confirmed that the majority of DBK was degraded by ACE and C…

Update on the effects of graded motor imagery and mirror therapy on complex regional pain syndrome type 1: A systematic review.

2017

Graded motor imagery (GMI) and mirror therapy (MT) is thought to improve pain in patients with complex regional pain syndrome (CRPS) types 1 and 2. However, the evidence is limited and analysis are not independent between types of CRPS. The purpose of this review was to analyze the effects of GMI and MT on pain in independent groups of patients with CRPS types 1 and 2. Searches for literature published between 1990 and 2016 were conducted in databases. Randomized controlled trials that compared GMI or MT with other treatments for CRPS types 1 and 2 were included. Six articles met the inclusion criteria and were classified from moderate to high quality. The total sample was composed of 171 p…

The Valencia consensus-based adaptation of the IASP complex regional pain syndrome diagnostic criteria

2021

Refereed/Peer-reviewed The new IASP diagnostic criteria for complex regional pain syndrome (CRPS) (aka “the Budapest Criteria”3; Table 1) have improved the diagnostic specificity for CRPS while maintaining good sensitivity. Internationally, these criteria are now in common use. The IASP CRPS Special Interest Group convened a workshop of CRPS experts in Valencia/Spain in September 2019 to review perceived ambiguities in the diagnostic text and issues identified in applying these criteria in both the research and clinical contexts. After this review, workshop attendees discussed and reached a consensus regarding adaptations to the diagnostic taxonomy text. This process resulted in pragmatic u…

Increased pain and neurogenic inflammation in mice deficient of neutral endopeptidase

2009

The complex regional pain syndrome (CRPS) is characterized by enhanced neurogenic inflammation, mediated by neuropeptides. Neutral endopeptidase (NEP) is a key enzyme in neuropeptide catabolism. We used NEP knock out (ko) mice to investigate whether NEP deficiency leads to increased pain behavior and signs of neurogenic inflammation after soft tissue trauma with and without nerve injury. After chronic constriction injury (CCI) of the right sciatic nerve, NEP ko mice were more sensitive to heat, to mechanical stimuli, and to cold than wild type mice. Tissue injury without nerve injury produced no differences between genotypes. After CCI, NEP ko mice showed increased hind paw edema but lower …

Complex regional pain syndrome: An optimistic perspective.

2014

Complex regional pain syndrome (CRPS) presents with clinical symptoms that can no longer be explained by the initial trauma, including pain, sensory, motor, and trophic symptoms, and impairment of autonomic control of the limb. These symptoms spread distally and go beyond single nerve innervation territories. Typically, the symptoms change through the course of CRPS as a result of the varying pathophysiology. Diagnosis is made clinically after the rigorous elimination of other possible causes, and 3-phase bone scintigraphy can be a useful tool for confirming CRPS. In acute stages, inflammatory symptoms prevail and should be treated with anti-inflammatory agents (steroids), bisphosphonates, …