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[Treatment of posttraumatic dystrophy].

C J Vecht1

  • 1Medisch Centrum Haaglanden, afd. Neurologie, Den Haag. ch.vecht@wxs.nl

Nederlands Tijdschrift Voor Geneeskunde
|September 6, 2000
PubMed
Summary

Complex regional pain syndrome (CRPS) is a chronic pain condition. Early physical therapy is the only clearly effective treatment, offering pain relief and cost reduction.

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Area of Science:

  • Neurology
  • Pain Management
  • Rehabilitation Medicine

Context:

  • Complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy or posttraumatic dystrophy, is a challenging chronic pain condition.
  • The exact etiology of CRPS remains unclear, with theories involving neuropathic mechanisms and psychogenic factors.
  • Current therapeutic strategies primarily focus on sympathetic nervous system modulation, but clinical trials have yielded limited success.

Purpose:

  • To review the current understanding and treatment efficacy for complex regional pain syndrome.
  • To evaluate the effectiveness of various therapeutic interventions for CRPS.
  • To identify optimal management strategies for chronic pain associated with CRPS.

Summary:

  • Pharmacological interventions, including guanethidine, phenylephrine, phentolamine, lidocaine, glucocorticoids, dimethylsulphoxide, biphosphonates, and epidural clonidine, have shown limited or inconclusive efficacy.
  • Electrical spinal cord stimulation presents a potential avenue, but requires further randomized controlled studies.
  • Early-stage physical therapy has demonstrated clear effectiveness in pain relief and cost reduction for CRPS patients.

Impact:

  • Highlights the limited success of current pharmacological and interventional treatments for CRPS.
  • Emphasizes the critical role of early physical therapy as a primary, evidence-based treatment.
  • Suggests directions for future research, including larger randomized trials for spinal cord stimulation.

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