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Reg Anesth Pain Med 2019 Mar;44(3):376-387

Department of Pain Management, Cleveland Clinic, Cleveland, OH 44024, USA

This account of the condition now termed complex regional pain syndrome (CRPS) spans approximately 462 years since a description embodying similar clinical features was described by Ambroise Paré in 1557. While reviewing its historical origins, the text describes why it became necessary to change the taxonomies of two clinical syndromes with similar pathophysiologies to one which acknowledges this aspect but does not introduce any mechanistic overtones. Discussed at length is the role of the sympathetic component of the autonomic nervous system (ANS) and why its dysfunction has both directly and indirectly influenced our understanding of the inflammatory aspects of CRPS. Read More

Pain 2019 Feb 8. Epub 2019 Feb 8.

Dept. of Endocrine Research, Medical Hospital I, BG University Hospitals Bergmannsheil Bochum.

Local osteopenia and altered bone metabolism are major complications of complex regional pain syndrome (CRPS), but quantitative assessment is difficult unless using X-ray or dual-energy X-ray absorptiometry. Ultrasound-based measurement of bone density (UBD) is a possible alternative, but has never been used to detect unilateral disease such as CRPS. Therefore, the main outcome measure of this prospective study was the diagnostic utility of UBD in patients with lower limb CRPS. Read More

Medicine (Baltimore) 2019 Feb;98(5):e14282

Department of Anesthesiology and Pain Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Pulsed radiofrequency (PRF) to the thoracic sympathetic ganglion (TSG PRF) or to the cervical sympathetic chain (CSC PRF) can be performed to overcome transient effects of single sympathetic blocks in patients with upper-extremity complex regional pain syndrome (CRPS).We retrospectively compared the clinical effects of TSG PRF and CSC PRF. Seven TSG PRF cases and 10 CSC PRF cases were enrolled in the present analysis. Read More

Br J Pain 2019 Feb 13;13(1):35-42. Epub 2018 Jun 13.

SI 'Institute of Traumatology and Orthopedics of the Academy of Medical Sciences of Ukraine', Kyiv, Ukraine.

Introduction: Mirror therapy requires a minimum of equipment, is relatively simple to perform and effective for various pathological conditions. The effect of mirror therapy on body schema disturbances registered in complex regional pain syndrome type I (CRPS I) patients has not yet been determined.

Methods: The study is based on the analysis of the treatment results of 30 patients with CRPS I, developed as a result of the distal radius fractures, with help of mirror therapy together with exercise therapy and medications. Read More

Transplant Proc 2018 Dec 8;50(10):4090-4095. Epub 2018 Sep 8.

Department of Pharmacy, Tianjin First Central Hospital, Tianjin, China.

Background: Calcineurin-inhibitor-induced pain syndrome (CIPS), a rare complication seen in patients with bone marrow transplants, is associated with the use of cyclosporine A (CsA) or tacrolimus (FK506). This case demonstrates the successful pain control of FK506-related CIPS in a 23-year-old male patient with previously reported characteristic clinical features of CIPS in addition to neuropathic symptoms and uncharacteristic imaging findings. On day 15 after the transplantation, the patient complained of severe pain in the lower limbs. Read More

Medicine (Baltimore) 2018 Dec;97(50):e13272

Division of Pain Medicine, Department of Anesthesiology, Hospital for Special Surgery, Weill Cornell Medicine, New York, New York.

Rationale: Continuous epidural infusion of local anesthetic may be an alternative to sympathetic blocks in refractory cases of complex regional pain syndrome (CRPS). Spinal epidural abscess (SEA) is a well-known complication associated with this technique, especially in patients with immune deficiencies. We herewith report a cervical SEA associated with an epidural catheter in a woman with CRPS and selective IgG3 subclass deficiency. Read More

Neurotherapeutics 2019 Jan;16(1):9-25

Division of Plastic and Reconstructive Surgery, Washington University in St. Louis, St. Louis, MO, USA.

Pain is a frequent cause of physician visits. Many physicians find these patients challenging because they often have complicated histories, emotional comorbidities, confusing examinations, difficult problems to fix, and the possibility of factitious complaints for attention or narcotic pain medications. As a result, many patients are lumped into the category of chronic, centralized pain and relegated to pain management. Read More

Plast Reconstr Surg Glob Open 2018 Oct 16;6(10):e1847. Epub 2018 Oct 16.

Elite Plastic Surgery, Phoenix, Arizona.

Background: Complex regional pain syndromes (CRPS) is a disease that is poorly understood. It is a chronic pain syndrome characterized by sympathetic disruptions as well as CNS sensitization. Botulinum Toxin-A has been shown to have efficacy in Raynaud's as well as other neuropathic pain disorders. Read More

J Hand Surg Asian Pac Vol 2018 Dec;23(4):554-561

* Department of Occupational Therapy, The University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

Background: To investigate the role of psychological factors (anxiety and depression) and pain measured on a visual analogue scale (VAS) in the development of complex regional pain syndrome type I (CRPS I) following the distal radius fracture (DRF).

Methods: A consecutive sample of patients (N=60) with a distal radius fracture was measured for signs of CRPS by Budapest criteria weekly till 8 weeks and then another follow-up one year after injury to determine the incidence and predictors of developing CRPS I in a prospective cohort study and also to discover whether there is difference between pain, depression, and anxiety level in the patients with and without CRPS I. The most of the patients were treated by Pin stabilization. Read More

Pain Res Manag 2018 17;2018:2894360. Epub 2018 Oct 17.

Department of Anaesthesiology and Intensive Care Medicine, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.

Background: Complex regional pain syndrome (CRPS) is a multifactorial disorder with complex aetiology and pathogenesis. At the outpatient pain clinic of Magdeburg University Hospital, all patients, without exception, are subject to permanent psychiatric care delivered by a consultation-liaison psychiatrist. In CRPS, psychological stabilization and treatment of the neuropathic aspects are equally important. Read More

Medicine (Baltimore) 2018 Nov;97(45):e13115

Department of Anesthesia, St. Joseph's Hospital, McMaster University, Hamilton, Ontario, Canada.

Rationale: Ehlers-Danlos syndromes (EDSs) are a heterogeneous group of heritable connective tissue disorders involving defective collagen synthesis. Patients with EDS are prone for chronic myofascial pain, apart from other comorbidities. Although the initial pathology is commonly nociceptive, progression of EDS leads to neuropathies and central sensitization of pain signals. Read More

Pain Manag 2018 Nov 5;8(6):427-436. Epub 2018 Nov 5.

Institute for Pain Medicine/Pain Practice Wiesbaden, Germany.

Aim: The secretolytic drug ambroxol may be useful for the treatment of neuropathic pain due to its multiple modes of action. We hypothesized that ambroxol may be a treatment option for complex regional pain syndrome (CRPS).

Methods: Additional to standard therapy, eight CRPS-patients with symptoms of less than 12 months were treated with topical 20% ambroxol cream. Read More

J Clin Apher 2018 Dec 2;33(6):661-665. Epub 2018 Nov 2.

Clinical Ethics, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom.

Background: Complex regional pain syndrome (CRPS) is a severe post-traumatic chronic pain condition affecting distal limbs, for which few effective treatments exist. Complex regional pain syndrome is listed in the 2016 American Society for Apheresis guidelines as an indication for plasma exchange treatment, but patient perspectives are lacking.

Study Design And Methods: We convened a "patient and public consultation exercise. Read More

Br J Anaesth 2018 Nov 24;121(5):1133-1137. Epub 2018 Aug 24.

Department of Anesthesiology and Pain Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address:

Background: Discrepancy between a patient's subjective thermal symptoms and objective measured temperature value is common in complex regional pain syndrome (CRPS) in clinical settings. For that reason, the diagnostic validity of a single temperature measurement method has been criticised. Several studies showed that the perfusion index (PI), which is derived from pulse oximetry, is a more sensitive and earlier indicator of sympathetic blockade than temperature measurement. Read More

BMJ Case Rep 2018 Oct 16;2018. Epub 2018 Oct 16.

USAT College of Medicine, University of Science, Arts & Technology, Olveston, Montserrat.

A 34-year-old man with a history of gunshot wound (GSW) to the right upper chest developed secondary aortic valve endocarditis (AVE) and was treated with an artificial valve placement (AVP). Three months after, he presented to an outpatient pain management clinic right arm pain and was diagnosed with complex regional pain syndrome type II (CRPS II). The patient underwent a diagnostic sympathetic ganglion block, before undergoing endoscopic thoracic sympathectomy surgery. Read More

N Engl J Med 2018 Oct;379(16):1575-1577

Pain Pract 2019 Feb 5;19(2):168-175. Epub 2018 Nov 5.

Department of Pain Medicine, BG University Hospital Bergmannsheil GmbH, Ruhr University, Bochum, Germany.

Background: The early phase of complex regional pain syndrome (CRPS) is characterized by an inflammatory state and therefore often treated with anti-inflammatory acting glucocorticoids. Recently, we demonstrated that remote ischemic conditioning (RIC), a cyclic application of nondamaging ischemia on a remote extremity, reduces blood flow and increases oxygen extraction in the CRPS-affected extremity.

Aim: The aim of the presented study was to analyze the effect of short-term pain treatment including glucocorticoid pulse treatment on the RIC-induced perfusion parameters. Read More

Neuromodulation 2019 Jan 24;22(1):1-35. Epub 2018 Sep 24.

Evidence-Based Pain Management Research and Education, Cleveland Clinic, Cleveland, OH, USA.

Introduction: The Neuromodulation Appropriateness Consensus Committee (NACC) is dedicated to improving the safety and efficacy of neuromodulation and thus improving the lives of patients undergoing neuromodulation therapies. With continued innovations in neuromodulation comes the need for evolving reviews of best practices. Dorsal root ganglion (DRG) stimulation has significantly improved the treatment of complex regional pain syndrome (CRPS), among other conditions. Read More

Mol Pain 2018 Jan-Dec;14:1744806918799127. Epub 2018 Aug 20.

3 Palo Alto Veterans Institute for Research, Palo Alto, CA, USA.

Complex regional pain syndrome (CRPS) is a highly enigmatic syndrome typically developing after injury or surgery to a limb. Severe pain and disability are common among those with chronic forms of this condition. Accumulating evidence suggests that CRPS may involve both autoinflammatory and autoimmune components. Read More

Med Hypotheses 2018 Oct 29;119:41-53. Epub 2018 Jul 29.

Hunter Pain Clinic, 91 Chatham Street, Broadmeadow, NSW 2292, Australia.

Complex Regional Pain Syndrome (CRPS) has defied a clear unified pathological explanation to date. Not surprisingly, treatments for the condition are limited in number, efficacy and their ability to enact a cure. Whilst many observations have been made of physiological abnormalities, how these explain the condition and who does and doesn't develop CRPS remains unclear. Read More

Nurs Clin North Am 2018 09;53(3):349-360

Department of Anesthesia, Wooden Anesthesia PC, Boone County Medical Center, 406 S 8th Street, Albion, NE 68620, USA.

Management of chronic pain has become a significant challenge for primary care providers, and the population of patients with chronic pain is expected to increase. Common syndromes seen in the primary care setting include myofascial pain syndrome, fibromyalgia, chronic postsurgical pain, complex regional pain syndrome, and painful diabetic neuropathy. This article describes these syndromes and presents current treatment options. Read More

PLoS One 2018 9;13(8):e0201354. Epub 2018 Aug 9.

Center for Rehabilitation of Pain Syndromes, Reuth Rehabilitation Hospital, Tel Aviv, Israel.

Objective: Complex Regional Pain Syndrome (CRPS), a chronic pain condition, develops mainly after limb trauma and severely inhibits function. While early diagnosis is essential, factors for CRPS onset are elusive. Therefore, identifying those at risk is crucial. Read More

Rev Neurol (Paris) 2018 Dec 24;174(10):671-674. Epub 2018 Jul 24.

Unité de soins intensifs neuro-vasculaires et réseau bourgogne-AVC, CHU de Dijon Bourgogne, 14, rue Paul-Gaffarel, 21079 Dijon cedex, France.

Pain after stroke (PAS) is a common clinical problem that is both underdiagnosed and undertreated. Yet, it induces depression and cognitive troubles, and impairs quality of life. To provide tools for practitioners, this report describes the most common PAS syndromes, including central post-stroke pain, spasticity and contractures, shoulder pain and complex regional pain syndromes, as well as headache and chondrocalcinosis, along with their risk factors, their prevention and their specific treatments. Read More

World Neurosurg 2018 Nov 23;119:e235-e243. Epub 2018 Jul 23.

Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea.

Objective: The aim of this study is to determine the risk factors affecting intraoperative neurophysiologic monitoring (IONM) changes, when such changes take place, and clinical outcomes associated with IONM change during cervical open door laminoplasty (COL) for cervical compressive myelopathy.

Methods: Between 2010 and 2015, 79 patients who underwent COL with IONM recording were studied. Changes in motor evoked potentials or somatosensory evoked potentials over an alarm criterion were defined as IONM change. Read More

Int J Technol Assess Health Care 2018 Jan 26;34(4):400-409. Epub 2018 Jul 26.

Department of Clinical Psychological Science,Maastricht University CAPHRI - School for Public Health and Primary Care, Department of Rehabilitation Medicine, Maastricht University.

Objectives: The aim of this study was to evaluate the cost-effectiveness of exposure in vivo (EXP, a cognitive-behavioral treatment targeting pain-related fear) in Complex Regional Pain Syndrome Type I (CRPS-I), as compared to pain-contingent physical therapy (PPT).

Methods: Data from a randomized controlled trial were used to compare the cost-effectiveness of EXP versus PPT from a societal perspective. Intervention costs, other healthcare costs, costs to patient and family, and productivity losses were included. Read More

Ann Rheum Dis 2018 Oct 14;77(10):1397-1404. Epub 2018 Jul 14.

Rheumatology Department, Regional Center for Autoimmune and Rheumatic Diseases (Centro Regional de Enfermedades Autoinmunes y Reumaticas, CREAR), Rosario, Santa Fe, Argentina.

Epidemiological studies in Latin America suggest indigenous people lack proper healthcare for musculoskeletal (MSK) and rheumatic diseases.

Objectives: This study aimed to estimate the prevalence of MSK disorders and rheumatic diseases in eight Latin American indigenous communities, and to identify which factors influence such prevalence using network analysis and syndemic approach.

Methods: This is a cross-sectional, community-based census study according to Community-Oriented Program for the Control of Rheumatic Diseases methodology. Read More

Medicine (Baltimore) 2018 Jul;97(28):e11492

Rationale: Evidence from cadaveric studies note that the sympathetic nerves from the second and third thoracic ganglia bypass the stellate ganglion in 20% of the population. We present a novel alternative technique for sympathetic blockade of upper extremity via thoracic epidural approach.

Patient Concerns: The patient-reported anxiety about "the placement of the needle in the front of the neck" and severe pain secondary to complex regional pain syndrome. Read More

Medicine (Baltimore) 2018 Jun;97(26):e11301

Department of Psychiatry, Hofstra Northwell Health-Staten Island University Hospital, Staten Island, New York.

Rationale: To present an unusual extrapyramidal motor response occurring after a sympathetic block in CRPS and its successful treatment with diphenhydramine.

Patient Concerns: Severe pain related to Complex Regional Pain Syndrome type 1 interfering with activities of daily living.

Diagnoses: Complex Regional Pain Syndrome type 1. Read More

Scand J Pain 2013 Jan 1;4(1):3-7. Epub 2013 Jan 1.

Center for Cancer Treatment, Sørlandet Hospital Trust, Kristiansand, Norway.

Background Neuropathic pain remains a significant challenge with unsatisfactory therapeutic options. Its pathogenesis may involve the neuropathic triad of neuronal, glial and immune cells. Communication between these cells is possibly perpetuated by mitogen-activated protein kinase (MAPK)-signaling. Read More

Scand J Pain 2013 Oct 1;4(4):200-207. Epub 2013 Oct 1.

Pain Center, Department of Anesthesia and Intensive Care, Akademiska sjukhuset, Uppsala, Sweden.

Background and purpose This case of a 42 year old woman with lower extremity Complex Regional Pain Syndrome (CRPS) after a twisting injury of the ankle, effectively treated with the addition of mirror therapy to a rehabilitation programme, prompted a literature review of both CRPS and mirror therapy. Mirror therapy is a newer adjunct to other forms of pain control and functional restoration for treatment of CRPS as well as other difficult clinical problems. This was a required group project as part of a university based course in chronic pain for healthcare workers. Read More

Clin Neurol Neurosurg 2018 Aug 10;171:156-162. Epub 2018 Jun 10.

Department of Neurosurgery - Neurological and Neurosurgical Clinic of Joinville, Brazil. Electronic address:

Objective: Spinal cord stimulation has been proven highly effective in the treatment of Complex Regional Pain Syndrome (CRPS). The definitive implantation of a neurostimulator is usually preceded by a therapeutic test (trial), which has the purpose of identifying whether the patient would respond positively to neuromodulation or not. The present study aims to analyze the surgical results of spinal cord stimulation in type 1 CRPS patients who have not undergone trial. Read More

PLoS One 2018 13;13(6):e0198514. Epub 2018 Jun 13.

Departments of Pharmacology and Anesthesiology, New York Medical College, Valhalla, New York, United States of America.

The principal finding from this study was the recognition that the α-adrenergic antagonist, phenoxybenzamine, possesses histone deacetylase inhibitory activity. Phenoxybenzamine is approved by the United States Food and Drug Administration for the treatment of hypertensive crises associated with tumors of the adrenal medulla, pheochromocytomas. It has several "off label" indications relative to its capacity to relax vascular smooth muscle and smooth muscle of the urogenital tract. Read More

Int J Pharm Compd 2018 Mar-Apr;22(2):172-175

Division of Pain Medicine, Keck School of Medicine of USC, Los Angeles, California.

The purpose of this study was to evaluate the effectiveness and adverse effects of topical ketamine in the treatment of complex regional pain syndrome. Retrospective charts were reviewed of patients 18 years or older diagnosed with complex regional pain syndrome and treated with topical ketamine during the study period of May 2006 to April 2013 in an academic medical center specialty pain clinic. Exclusion criteria consisted of subjects who 1) were treated with topical ketamine for pain syndromes other than complex regional pain syndrome, 2) initiated other pain therapies concurrently with topical ketamine, 3) had less than two documented visits, 4) began use of topical ketamine prior to the start of the study period, 5) were under 18 years of age. Read More

Front Integr Neurosci 2018 23;12:18. Epub 2018 May 23.

Department of Psychology, Hofstra University, Hempstead, NY, United States.

Chronic pain can result from many pain syndromes including complex regional pain syndrome (CRPS), phantom limb pain and chronic low back pain, among others. On a molecular level, chronic pain syndromes arise from hypersensitization within the dorsal horn of the spinal cord, a process known as central sensitization. Central sensitization involves an upregulation of ionotropic and metabotropic glutamate receptors (mGluRs) similar to that of long-term potentiation (LTP). Read More

Pain Physician 2018 05;21(3):E207-E214

Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital/Harvard, Boston, MA; Department of Anesthesiology, LSU School of Medicine, New Orleans, LA.

Background: Chronic pain is a major public health problem resulting in physical and emotional pain for individuals and families, loss of productivity, and an annual cost of billions of dollars. The lack of objective measures available to aid in diagnosis and evaluation of therapies for chronic pain continues to be a challenge for the clinician.

Objectives: Functional magnetic resonance imaging (fMRI) is an imaging technique that can establish regional areas of interest and examine synchronous neuronal activity in functionally related but anatomically distinct regions of the brain, known as functional connectivity. Read More

Med Sci Law 2018 Jul 4;58(3):147-155. Epub 2018 Jun 4.

2 The London School of Medicine and Dentistry, UK.

Objective The aim of this study was to review demographic and clinical characteristics of patients with complex regional pain syndrome type 1 (CRPS) seen in a UK medico-legal setting - particularly the relationship between CRPS and somatoform disorders. Methods Fifty consecutive cases of CRPS (interviewed 2005-2016) undergoing psychiatric assessment were reviewed. A systematic assessment of mental states was conducted via interview and examination of medical/psychiatric records. Read More

PLoS One 2018 4;13(6):e0198147. Epub 2018 Jun 4.

Department of Anesthesiology and Pain Medicine, Wonkwang University College of Medicine, Iksan, Republic of Korea.

Chronic regional pain syndrome (CRPS) is an inflammatory and neuropathic pain disorder characterized by the involvement of the autonomic nervous system with sensory, autonomic, motor, skin, and bone changes. At present, universally accepted consensus criteria for CRPS are not yet established, despite the diagnostic criteria proposed by the International Association for the Study of Pain (IASP). Various hypotheses for the pathophysiology of CRPS have been proposed; as a result, current therapeutic modalities are varied. Read More

Int J Orthop Trauma Nurs 2018 Aug 19;30:44-47. Epub 2018 Mar 19.

Institute of Health and Social Care Studies, Princess Elizabeth Hospital, Guernsey. Electronic address:

Practice development enables the practitioner to develop their knowledge and allow the application of evidence based care for patients. It happens within the practitioner's own clinical practice area and enhances personal and professional growth whilst focusing on patients' specific needs. This is important with a condition such as Complex Regional Pain Syndrome (CRPS), with patients seekingaccurate and timely diagnosis and coping strategies to support them in everyday activities. Read More

Bull Hosp Jt Dis (2013) 2018 Jun;76(2):123-132

Faced with a patient who presents with unexplained disproportionate pain, a surgeon may be tempted to diagnose a low pain threshold, malingering, poor coping, anxiety, or other emotional condition. However, a variety of conditions must be ruled out before the orthopedist can prescribe watchful waiting. Computed tomography and magnetic resonance imaging can detect occult fractures, acute spinal conditions or vascular occlusions, but early on are inadequate to diagnose a compartment syndrome, necrotizing fasciitis, or reflex sympathetic dystrophy (RSD). Read More

Curr Pain Headache Rep 2018 May 23;22(6):45. Epub 2018 May 23.

Department of Neurosurgery, University of Illinois at Chicago, 912 South Wood Street, 451-N NPI, (MC 799), Chicago, IL, 60612, USA.

Purpose Of Review: Since the early 1990s, motor cortex stimulation (MCS) has been a unique treatment modality for patients with drug-resistant deafferentation pain. While underpowered studies and case reports have limited definitive, data-driven analysis of MCS in the past, recent research has brought new clarity to the MCS literature and has helped identify appropriate indications for MCS and its long-term efficacy.

Recent Findings: In this review, new research in MCS, repetitive transcranial magnetic stimulation (rTMS), and transcranial direct current stimulation (tDCS) are analyzed and compared with historical landmark papers. Read More

Medicine (Baltimore) 2018 05;97(20):e10784

Department of Rehabilitation Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.

Rationale: We report a case of a 61-year-old patient who developed complex regional pain syndrome (CRPS) type II after a cervical transforaminal epidural steroid injection (CTESI).

Patient Concerns: The patient developed sudden-onset severe pain and swelling of his upper right limb after a cervical transforaminal epidural injection.

Diagnoses: On physical examination, the patient's symptoms and signs corresponded to the Budapest criteria for CRPS. Read More

Prim Care 2018 Jun;45(2):289-303

Rheumatology Fellowship, San Antonio Uniformed Services Health Education Consortium (SAUSHEC), Uniformed Services University of the Health Sciences, San Antonio Military Medical Center, 3551 Roger Brooke Drive, San Antonio, TX 78234, USA.

Soft tissue musculoskeletal pain disorders are common in the primary care setting. Early recognition and diagnosis of these syndromes minimizes patient pain and disability. This article gives a brief overview of the most common soft tissue musculoskeletal pain syndromes. Read More

Medicine (Baltimore) 2018 May;97(19):e0705

Department of Anesthesiology and Reanimation, Izmir Tepecik Research and Training Hospital - Health Sciences University, Izmir, Turkey.

Rationale: To present the successful treatment of complex regional pain syndrome type -1 utilizing sympathetic blocks.

Patient Concerns: Severe pain interfering with activities of daily living and temporary disability secondary to complex regional pain syndrome.

Diagnoses: Complex regional pain syndrome type-1 with involvement of lower extremity (2 patients), and upper extremity (1 patient). Read More

Medicine (Baltimore) 2018 May;97(19):e0694

Department of Anesthesiology and Pain Medicine, Haeundae Paik Hospital of Inje University, Busan, Republic of Korea.

Rationale: CRPS after a lumbar surgery has symptoms that are similar to PSSS. However, standard criteria for distinguishing CRPS from PSSS do not exist. We present a case report of a 31-year-old female with CRPS symptoms after lumbar spinal surgery treated by performing SELD. Read More

J Drugs Dermatol 2018 May;17(5):532-536

Reflex sympathetic dystrophy is a subtype of complex regional pain syndrome, a condition characterized by persistent post-injury extremity pain. Temperature and sweating changes, edema, mobility changes, and a variety of hair, nail, and skin sequelae have been described. Only 23 articles published since 1990 describe dermatologic changes in CRPS. Read More

Best Pract Res Clin Anaesthesiol 2017 Dec 16;31(4):547-560. Epub 2017 Nov 16.

Tufts University School of Medicine, Tufts Medical Center, Department of Anesthesiology and Perioperative Medicine, 800 Washington St, Boston, MA, 02111, USA. Electronic address:

Opioid-free anaesthesia (OFA) is a technique where no intraoperative systemic, neuraxial or intracavitary opioid is administered with the anaesthetic. Opioid-free analgesia similarly avoids opioids in the perioperative period. There are many compelling reasons to avoid opioids in the surgical population. Read More

Kaohsiung J Med Sci 2018 Apr 8;34(4):231-237. Epub 2018 Feb 8.

Department of Endodontics School of Dental Medicine University of Pennsylvania Philadelphia, Pennsylvania, USA. Electronic address:

In the last few decades, neurobiological and human brain imaging research have greatly advanced our understanding of brain mechanisms that support perception and memory, as well as their function in daily activities. Knowledge of the neurobiological mechanisms behind the deafferentation of stomatognathic systems has also expanded greatly in recent decades. In particular, current studies reveal that the peripheral deafferentations of stomatognathic systems may be projected globally into the central nervous system (CNS) and become an associated critical factor in triggering and aggravating neurodegenerative diseases. Read More

Eur J Pain 2018 08 25;22(7):1343-1350. Epub 2018 Apr 25.

Department of Neurology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.

Background: Complex regional pain syndrome (CRPS) is associated with deficits in limb recognition. The purpose of our study was to determine whether mental load during this task affected performance, sympathetic nervous system activity or pain in CRPS patients.

Methods: We investigated twenty CRPS-I patients with pain in the upper extremity and twenty age- and sex-matched healthy controls. Read More

A A Pract 2018 Sep;11(6):158-159

From the Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.

Fluoroquinolones are a class of popular outpatient antimicrobial agents with a wide spectrum of therapeutic indications for respiratory and genitourinary infections. Though the most common side effects are gastrointestinal, fluoroquinolones have been increasingly associated with neurotoxicity including peripheral neuropathy and seizures. We present here a case of a 43-year-old woman with previously resolved type I complex regional pain syndrome (CRPS) who presented with symptoms of CRPS and neurotoxicity in the setting of levofloxacin administration. Read More