This is a pdf file of an unedited manuscript that has. Mechanismbased treatment in complex regional pain syndromes. An understanding of the underlying pain mechanisms is helpful in the logical direction of treatment, particularly in chronic pain states, such as phantom limb pain or complex regional pain syndrome. Crps is believed to be caused by damage to, or malfunction of, the peripheral and central. Pain exposure physical therapy may be a safe and effective. Mechanismbased treatment of chronic nonterminal pain, and responding to sb1446 rachel franklin, m. Mechanismbased treatment of chronic nonterminal pain, and. Usually, crps develops in a peripheral limb after a trauma or surgery and is characterized by pain, as typical burning pain, accompanied by allodynia and hyperalgesia, disproportionate to the inciting event and by a variety of autonomic disturbances and trophic abnormalities. Complex regional pain syndromes crps are multifactorial disorders with complex aetiology and pathogenesis.
Various complications of complex regional pain syndrome. Pdf despite the severe pain and disability associated with complex regional. Management of complex regional pain syndrome should be directed towards the cause of the neuro. Complex regional pain syndrome crps is an unrelenting pain syn drome tha t affects millions of people world wide. Reviews of available randomized trials suggest that physical and occupational therapy including.
Janne gierthmuhlen janne gierthmuhlen is a physician and a senior researcher in the division of neurological pain research and therapy, department of neurology, university of kiel, germany. Based on bedside neurological testing, it has recently been shown that 33% of chronic complex regional pain syndrome crps type i patients exhibit sensory impairments, which extend past the. C omplex regional pain syndrome crps is a chronic lasting greater than six months pain condition that most often affects one limb arm, leg, hand, or foot usually after an injury. Phillips neurological associates pain management center vero beach, florida abstract. This condition affects vascular, nervous, skeletal, integumentary and immune systems. By determining the most prominent mechanism, physicians can use specific therapies to target these mechanisms fig. Management of crps is challenging, partly because of a lack of clinical data regarding the efficacy of the various therapies, and partly because successful treatment of crps requires a multidisciplinary, patienttailored approach. Complex regional pain syndrome crps is a multifactorial and disabling disorder with complex etiology and pathogenesis. Cortical reorganization during recovery from complex regional pain syndrome. Complex regional pain syndrome is a chronic pain condition characterized by autonomic. Pharmacologic treatment of complex regional pain syndrome i. Complex regional pain syndrome crps is initiated by dysfunction of.
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