This book provides an up-to date, extensive, and focused review of complex regional pain syndrome (CRPS). It reflects the current scientific understanding of the disorder, describes appropriate treatment recommendations, and explores future directions of diagnosis and treatment.
Divided into three sections, the first section covers the etiology and pathology of CRPS. The following section offers treatments and emerging advances in evaluation and/or treatment. The book then closes with an exploration of varying patient populations. Each chapter is authored by specialists experienced with CRPS research and treatment. Additionally, the review and recommendations provided reflect careful consideration of evidence-based medicine and medical consensus guidelines.
Complex Regional Pain Syndrome targets a range of healthcare specialties including pain management, rheumatology, neurology, internal medicine, and family practice.
Author(s): Erin F. Lawson, Joel P. Castellanos
Publisher: Springer
Year: 2021
Language: English
Pages: 364
City: Cham
Preface
Acknowledgments
Contents
Contributors
Part I: CRPS Basics
1: Complex Regional Pain Syndrome: An Introduction
Introduction
Diagnosis
Epidemiology
Risk Factors
Pathophysiology
Sympathetically Maintained Pain
Peripheral Sensitization
Central Sensitization
Acute-Warm-Peripheral CRPS Versus Chronic-Cold-Central CRPS
Oxidative Stress
Autoimmunity
Central Nervous System Alterations
Psychological Mechanisms
Natural History
Acute Versus Chronic
CRPS Spread
Conclusions
References
2: Peripheral Injury and CRPS
Peripheral Sensitization
Inflammatory Processes in CRPS
CRPS and Brain Plasticity
References
3: Differential Diagnosis of Complex Regional Pain Syndrome
Introduction
Neurologic
Nerve Entrapment Syndromes
Carpal Tunnel Syndrome
Distal Symmetric Polyneuropathies
Diabetic Polyneuropathy
HIV Polyneuropathy
Postherpetic Neuralgia
Neurogenic Claudication
Central Post-stroke Pain
Thoracic Outlet Syndrome
Vascular Disease
Peripheral Artery Disease and Ischemic Claudication
Lymphedema
Deep Vein Thrombosis and Thrombophlebitis
Erythromelalgia
Inflammatory Disease
Rheumatoid Arthritis
Infection and Cellulitis
Chronic Inflammatory Demyelinating Polyneuropathy
Gout
Myofascial Pain Syndromes
Sprains/Strains/Tendinopathies
Fibromyalgia
Psychological Syndromes
Somatoform Syndrome
Factitious Disorder/Munchausen’s Syndrome
Conclusion
References
Suggested Reading
4: Diagnostic Tests and Physical Exam for CRPS
Definition
Presentation and Physical Exam
Diagnosis Criteria
Severity of Disease
Diagnostic Tests
Thermography
Radionuclide Bone Scintigraphy
Diagnostic Imaging Techniques
Electromyography (EMG)
Musculoskeletal Ultrasound
Skin Biopsy
Conclusion
References
Part II: Treatment of CRPS
5: Pharmacologic Treatments for CRPS
Nonsteroidal Anti-inflammatory Drugs
Bisphosphonates
Calcitonin
Corticosteroids
Anticonvulsants and Antidepressants
Local Anesthetics
N-methyl D-aspartate (NMDA) Receptor Antagonists
Vitamin C
Opioids
Topical Agents
Botulinum Toxin
Immunoglobulins
Conclusion
References
Suggested Reading
6: Behavioral Health Interventions for CRPS
Diagnostic Considerations and Theoretical Foundations
Assessment
Functional Impact
Pain Coping
Psychiatric Comorbidities
Validated Measures
Behavioral Health Interventions
Cognitive Therapy
Psychoeducation
Reframing
Cognitive Restructuring
Behavioral Therapy
Activity Pacing (AP)
Graded Exposure
Physiological Self-regulation Strategies
Relaxation Training (RT)
Mindfulness-Based Interventions (MBI)
Self-Hypnosis
Biofeedback (BFB)
Acceptance and Commitment Therapy (ACT)
Case Example of ACT for CRPS
Motivational Interviewing (MI)
Group-Delivered Interventions
CBT Groups
Mindfulness- and Acceptance-Based Group Therapies
Patient Education: Explain Pain Groups
Innovative Digital Directions for the Field
Conclusions
References
7: Comprehensive Rehabilitation of Patients with Complex Regional Pain Syndrome
Introduction
Background
Medical Treatment in Interdisciplinary Rehabilitation
Interdisciplinary Medical Rehabilitation of CRPS: Assessment
Treatment Considerations in Medical Rehabilitation of CRPS: Interventions Used
Interdisciplinary Rehabilitation of CRPS: Physical Therapy
Interdisciplinary Rehabilitation of CRPS: Physical Therapy Assessment
Interdisciplinary Rehabilitation of CRPS: Physical Therapy Objective Measures
Interdisciplinary Rehabilitation of CRPS: Physical Therapy Interventions
Interdisciplinary Occupational Rehabilitation of CRPS
Interdisciplinary Occupational Rehabilitation of CRPS: Assessment
Interdisciplinary Occupational Rehabilitation of CRPS: Objective Measures
Interdisciplinary Occupational Rehabilitation of CRPS: Interventions
Interdisciplinary Psychological Rehabilitation of CRPS
Interdisciplinary Psychological Rehabilitation of CRPS: Assessment
Interdisciplinary Psychological Rehabilitation of CRPS: Objective Measures
Interdisciplinary Psychological Rehabilitation of CRPS: Interventions
Key Considerations, Limitations, and Barriers
Future Considerations
References
8: Adjuvant Treatments for CRPS
Introduction
Acupuncture
Movement-Based Mind-Body Practices (Qigong Therapy, Tai Chi, Yoga)
Relaxation-Based Mind-Body Techniques
Herbs and Supplements
Transcutaneous Electrical Stimulation
Noninvasive Brain Stimulation
Pulsed Electromagnetic Field Therapy
Prism Adaptation Therapy
Hyperbaric Oxygen Therapy
Ozone Therapy
Hirudotherapy
Physiotherapy-Based Interventions
Use of Adjuvants in Children With CRPS
Conclusion
References
9: Interventional Treatment of Complex Regional Pain Syndrome
Introduction
Intravenous Therapies
Description of IVRB
Complications
Intravenous Infusions and IVRB with Sympatholytic Agents
Intravenous Infusions and IVRB with Non-sympatholytic Agents
Sympathetic Blocks
Stellate Ganglion Block for Upper Extremity CRPS
Thoracic Sympathetic Block for Upper Extremity CRPS
Lumbar Sympathetic Block for Lower Extremity CRPS
Outcomes
Neuromodulation Therapies
Preoperative Considerations
Peripheral Nerve Block and Stimulation
Indication
Procedure
Outcomes
Complications
Spinal Cord Stimulation
Procedure
Complications
Outcomes
Intrathecal Drug Delivery Therapy
Procedure
Complications
Pharmacologic Agents
Concluding Remarks
References
10: Interventional Treatments for CRPS in Children
References
11: Emerging Therapies for the Treatment of Complex Regional Pain Syndrome
Introduction
Neuromodulation
Cost Efficacy
Dorsal Column Stimulation
Dorsal Root Ganglion Stimulation
Peripheral Nerve Stimulation
Brain Stimulation
Deep Brain Stimulation
Motor Cortex Stimulation
Transcranial Magnetic Stimulation
References
12: Treatment Algorithm for Complex Regional Pain Syndrome
Introduction
Definition and Terminology
Clinical Presentation
Diagnosis and Evaluation
Diagnostic Criteria
Investigations
Epidemiology
Incidence and Risk Factors
Surgery
Fracture
Pathophysiology
Inflammation
Central and Peripheral Sensitization
Altered Cutaneous Innervation
Altered Sympathetic Nervous System Function
Autoimmunity
Brain Plasticity
Genetic Factors
Psychological Factors
Management
Physiotherapy
Psychological Therapy
Medical Management
Surgical Management
Novel Therapeutic Approaches
Treatment Algorithm
Conclusion
References
Part III: Special Considerations in CRPS
13: Children and Adolescents with CRPS
Background
Epidemiology
Etiology and Pathogenesis
fMRI Data
Genetics
Psychological Factors
Other
Clinical Features
Diagnosis
Treatment
Physical and Occupational Therapy
Psychological Therapy
Medications
Invasive Treatments
Spinal Cord Stimulation
Alternative Treatments
Prognosis
Conclusion
Bibliography
14: Review and Management of Complex Regional Pain Syndrome in Pregnancy
Introduction
Pathophysiology
Clinical Symptoms
Diagnosis
Management
Pharmacotherapy
Antipyretics
Anti-Inflammatories
Tricyclic Antidepressants (TCAs)
Antiepileptics
Muscle Relaxants
Alpha-Adrenergic Agonists
Immunomodulators
Opioids
Other Oral Medications
Topicals
Botulinum Toxin
Ketamine
Cannabis (Marijuana)
Interventional Therapies
Trigger Point Injection
Sympathetic Nerve Block
Bier Block
Dorsal Root Ganglion Stimulation
Radiofrequency Ablation
Spinal Cord Stimulator
Acupuncture
Therapy and Modalities
Physical Therapy
Modalities
TENS
Contrast Bath
Fluidotherapy
Ultrasound
Occupational Therapy
Mirror Therapy
Chiropractic Care
Psychological and Behavioral Therapy
Cognitive Behavioral Therapy (CBT) and Other Behavioral Therapy
Biofeedback
Meditation and Relaxation
Hypnotherapy
Bibliography
15: Chronic Regional Pain Syndrome in the Geriatric Patient
Introduction
Epidemiology
Pathophysiology
Clinical Diagnosis
Clinical Presentation
Budapest Criteria
Assessing Pain in the Elderly
Treatment
Nonpharmacologic Treatments
Pharmacologic Treatments
Conclusion
References
16: Challenges and Controversies in Complex Regional Pain Syndrome (CRPS) Treatment
Sympathetic Blocks in CRPS
Which Sympathetic Blocks Can be Used and How Are They Performed?
Stellate Ganglia Block (SGB)
Ultrasound-Guided Technique
Fluoroscopically Guided Technique
CT-Guided Technique
Lumbar Sympathetic Block (LSB)
Fluoroscopically Guided Technique
Ultrasound-Guided Technique
Thoracic Sympathetic Block
Erector Spinae Plane Block
Intravenous Sympathetic Block
Is One Sympathetic Block Technique Superior to Another?
What Agents Can Be Used for Sympathetic Blocks?
Are Sympathetic Blocks Effective in Treating CRPS Pain?
Does the Response to Sympathetic Blocks Predict Success of Other Treatment Modality Such as Spinal Cord Stimulation?
Should Sympathetic Neurolysis Be Used to Treat CRPS Pain?
Summary of Sympathetic Block for CRPS
Intravenous Ketamine Infusion for CRPS
Is IV Ketamine Infusion Effective in Managing CRPS Pain?
What IV Ketamine Infusion Protocol Is Optimal?
Which Patients Are Likely to Respond to IV Ketamine Infusion?
What Are the Short- and Long-Term Consequences of IV Ketamine Infusion?
Summary of IV Ketamine Infusion for CRPS
Peripheral Nerve Stimulation for CRPS
Is PNS Effective in Treating CRPS? Which Patient Is Likely to Respond to PNS?
Is PNS Cost-Effective in Treating CRPS?
Summary of PNS for CRPS
Summary and Future Directions
References
Index
