Therapy for complex regional pain syndrome

Abstract

Other names: causalgia, algodystrophy, postraumatic dystrophy, Sudeck's atrophy, shoulder-hand syndrome, Reflex simpathetic dystrophy (RSD). RSD/CRPS is a multi-system syndrome with diverse symptoms characterized by constant pain. It affects the central nervous system, immune, autonomic and vascular system . Usually CRPS affects one or more extremities but it can affect any part of the body. CRPS symptoms vary in severity and duration. Anyone can get CRPS. It can strike at any age and affects both men and women. The average age of affected individuals is about age 38-40. Children do not get it before age 5, but it is not uncommon in teenagers. CRPS is rare in the elderly. Precipitating factors include injury and surgery. However, there is no relationship to the severity of trauma while in some cases there is no precipitating trauma at all (9%). The diagnosis of CRPS cannot be made on imaging or laboratory tests. The condition is diagnosed on the basis of clinical criteria “BUDAPESTA” - 2/4 presence of symptoms: sensory, vasomotor, sudomotor/oedema, motor/trophic. In 2011-2016, the IMS Private SRL MEDICORT addressed 19 patients with CRPS diagnosis: 4 - men, 15 - women.Two women had the severe form of CRPS. There is no simple cure for CRPS. Treatment often involves a number of approaches and aims to restore movement and function of the affected limb. Options may include: - medication – such as pain-relieving medications (non-steroidal anti-inflammatory drugs; Psychotropic drugs; corticosteroids that treat inflammation/swelling and edema; local anesthetic creams). - rehabilitation therapy – such as physiotherapy and occupational therapy. - counselling and psychological support –to help the person cope with stress, depression and constant pain. - intervention therapy – such as nerve blocks. The most commonly used is a sympathetic ganglion block, which involves the use of a local anaesthetic to stop some of the nerves in the affected limb from working. To achieve good results, we used Ultrasound Guided supraclavicular / axillary / Sciatic Nerve Block with local anesthetic and corticosteroids, with rehabilitation therapy for 30 minutes, 2-5 procedures in number every six days dependent CRPS clinical forms.