Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
  1. Home
  2. Search

Refine search

Refine search

Access:
Content type:
Publication date:
Apply   From and To filters
Subject: Show more
Journals Show more
Publishers: Show more
Societies Show more
Series: Show more
Collections: Show more

Actions for selected content:

Select all | Deselect all
  • View selected items
  • Export citations
  • Download PDF (zip)
  • Save to Kindle
  • Save to Dropbox
  • Save to Google Drive

Save Search

You can save your searches here and later view and run them again in "My saved searches".

Please provide a title, maximum of 40 characters.
Cancel
×

7 results

  • Chapter 27 - Complex Regional Pain Syndrome (CRPS)

  • from Part VI - Misc
  • Edited by Omar Viswanath, Creighton University, Omaha, Ivan Urits, Southcoast Brain & Spine Center, Wareham
  • Book:
    Cambridge Handbook of Pain Medicine
    Published online:
    01 December 2023
    Print publication:
    14 December 2023, pp 220-227

  • Summary

    Complex regional pain syndrome (CRPS) is a long-term pain condition that commonly affects the extremities and is associated with increased sensitivity to pain and touch. CRPS is classified into two types: CRPS-I and CRPS-II. The former occurs when there is no apparent nerve damage, whereas the latter is linked to known nerve damage. Psychological factors may play a role in the development of CRPS, with studies indicating that individuals with a history of depression and PTSD are at a higher risk of developing this condition. There are various treatment options available for CRPS, including physical therapy, medication, and interventional techniques such as nerve blocks and transcranial stimulation. However, larger and more comprehensive studies are needed to assess the effectiveness of these therapies. While NSAIDs have not been found to be effective in treating CRPS, sympathetic nerve blocks are commonly used but have mixed results. Finally, spinal cord stimulation (SCS) is a surgical treatment option that is recommended after conservative treatments have failed to produce significant symptom relief over several months.

  • Chapter 25 - The person with pain perspective and participation – an essential component of successfully managing chronic neuropathic pain

  • from Section 6 - The Management of Neuropathic Pain
  • Edited by Cory Toth, Dwight E. Moulin
  • Book:
    Neuropathic Pain
    Published online:
    05 December 2013
    Print publication:
    07 November 2013, pp 299-314

  • Summary

    Over the past 150 years, regional post-traumatic pain has had various appellations, most recently complex regional pain syndrome (CRPS) and post-traumatic neuralgia (PTN). CPRS appears to be a complex endophenotype of PTN that involves neurogenic inflammation as well as pain. There is increasing evidence that peripheral and central inflammatory cascades triggered by nerve injuries contribute to CRPS and perhaps PTN as well. PTN and CRPS often spread beyond classic individual nerve territories, although when patients are asked to outline the epicenter, or most abnormal area, this frequently identifies a specific nerve injury. The most dramatic CRPS and PTN-associated movement abnormality is fixed distal dystonia. Nerve conduction studies and electromyography are useful in documenting and localizing peripheral nerve damage. Currently, four classes of medications are primary options for chronic CRPS/PTN: tricyclics and serotonin-noradrenaline reuptake inhibitors; opioids; gabapentinoids; and topical or systemic local anesthetics.

  • Chapter 7 - Pathophysiology of neuropathic pain: inflammatory mediators

  • from Section 2 - The Condition of Neuropathic Pain
  • Edited by Cory Toth, Dwight E. Moulin
  • Book:
    Neuropathic Pain
    Published online:
    05 December 2013
    Print publication:
    07 November 2013, pp 77-89

  • Summary

    This chapter summarizes a standard approach to identifying neuropathic pain for the clinician. For neuropathic pain, and for the condition of complex regional pain syndrome (CRPS) especially, the six Ss should be queried when obtaining details regarding the affected region. A useful tool to rapidly and accurately localize sources of chronic pain and assist in the diagnosis of causes of neuropathic pain is a pain diagram. The examination of a chronic pain patient should start with an appropriate and directed general examination including a neurological examination. Quantitative sensory testing (QST) provides indirect information used to evaluate underlying sensory function abnormalities using only small, portable tools and with less time requirement than protocols developed by the German Neuropathic Research Network. In the future, bedside QST is expected to continue to play a role in determining potential pain mechanisms to help direct further evaluation and treatment.

  • Effort – What is it, How Should it be Measured?

  • Erin D. Bigler
  • Journal:
    Journal of the International Neuropsychological Society / Volume 17 / Issue 4 / 21 June 2011
    Published online by Cambridge University Press:
    06 June 2011, pp. 751-752
    • Article
      • You have access
    • PDF
    • HTML
    • Export citation

  • (JINS, 2011, 17, 751–752)

  • Neuropsychological deficits associated with Complex Regional Pain Syndrome

  • DAVID J. LIBON, ROBERT J. SCHWARTZMAN, JOEL EPPIG, DENENE WAMBACH, ERIC BRAHIN, B. LEE PETERLIN, GUILLERMO ALEXANDER, ATUL KALANURIA
  • Journal:
    Journal of the International Neuropsychological Society / Volume 16 / Issue 3 / May 2010
    Published online by Cambridge University Press:
    19 March 2010, pp. 566-573

  • We sought to elucidate the existence of neuropsychological subtypes in Complex Regional Pain Syndrome (CRPS). One hundred thirty seven patients with CRPS were administered tests that assess executive control, naming/lexical retrieval, and declarative memory. A 2-step cluster analysis that does not require any a priori specification regarding the number of clusters, classified patients into three groups. Group 1 obtained scores that were in the average range on all tests (n = 48; normal CRSP group). Group 2 (n = 58; dysexecutive CRSP group) presented with mild impairment or statistically low average test performance on working memory/verbal fluency tests. Group 3 (n = 31; global CRSP group) produced scores in the statistically low average/borderline range on all tests with particularly reduced scores on naming/declarative memory tests. Between-group analyses found that the CRPS group 1 obtained higher scores than CRPS groups 2 and 3 on all tests. However, groups 2 and 3 were equally impaired on executive tests. CRPS group 3 was impaired on tests of naming/memory tests compared to the other groups. Significant neuropsychological deficits are present in 65% of patients, with many patients presenting with elements of a dysexecutive syndrome and some patients presenting with global cognitive impairment. (JINS, 2010, 16, 566–573.)

  • Otitis media and externa

  • from Chief complaints and diagnoses
  • Edited by Stephen H. Thomas
  • Book:
    Emergency Department Analgesia
    Published online:
    18 December 2009
    Print publication:
    25 September 2008, pp 335-338

  • Summary

    This chapter covers both types (1 and 2) of complex regional pain syndrome (CRPS). CRPS type 2, also known as causalgia, is a true neuropathy. Of all of the types of neuropathic pain, CRPS (either type) is the most resistant to pharmacotherapy. Even traditionally endorsed approaches such as sympathetic blockade are found poorly efficacious in Cochrane review. In fact, RCT evidence does not conclusively confirm utility for any agent for CRPS. For CRPS type 2, two trials of IV infusion of bisphosphonates find that pain may be reduced by alendronate or clodronate. The anticonvulsant gabapentin, effective in a broad range of neuropathic pain syndromes, is of little utility in CRPS. There is limited evidence for use of systemic corticosteroids for CRPS type 2. This chapter finally discusses a small trial, assessing PO prednisone that has found some benefit compared with placebo.

  • Continuous axillary brachial plexus analgesia with low dose morphine in patients with complex regional pain syndromes

  • S. C. Azad, A. Beyer, A. W. Römer, A. Galle-Röd, K. Peter, P. Schöps
  • Journal:
    European Journal of Anaesthesiology / Volume 17 / Issue 3 / March 2000
    Published online by Cambridge University Press:
    16 August 2006, pp. 185-188
    Print publication:
    March 2000

  • In this prospective pilot study, nine patients suffering from complex regional pain syndrome of the arm were treated with morphine 0.16mg h−1 (3.84mg day−1) applied continuously through an axillary brachial plexus catheter. In all of them an oral analgesic medication including the less potent opioid tramadol had not provided sufficient pain relief. During regional treatment, patients were kept in hospital and physiotherapy was carried out frequently in order to improve strength and function of the affected arm. Pain at rest and during movement as well as grip strength were assessed at first visit, during morphine infusion and at a long–term follow–up visit. All assessments improved significantly during plexus analgesia. There were no major opioid related side–effects. The results from this pilot study indicate that continuous axillary brachial plexus analgesia with low dose morphine might be beneficial in patients suffering from complex regional pain syndrome of the arm.