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Complex regional pain syndrome post mastectomy.
L E Graham1, C McGuigan, S Kerr
1Registrar in Rheumatology, Musgrave Park Hospital, Belfast, Northern Ireland. lorradam@wlink.com.np
Rheumatology International
|February 15, 2002
Summary
Complex regional pain syndrome (CRPS), previously reflex sympathetic dystrophy, is a chronic pain condition. This study shows CRPS can develop in a limb after mastectomy for chronic mastalgia.
Area of Science:
- Pain Medicine
- Surgical Complications
- Neurology
Background:
- Complex regional pain syndrome (CRPS), formerly known as reflex sympathetic dystrophy, is a poorly understood chronic pain condition.
- CRPS is characterized by distinct symptoms and skin changes, often with a psychological component.
- It is an infrequent but recognized complication following surgical procedures, particularly mastectomy.
Observation:
- This report details two female patients who developed CRPS after undergoing mastectomy for chronic mastalgia.
- The syndrome manifested in the limb adjacent to the surgical site.
- These cases highlight a potential iatrogenic cause of CRPS.
Findings:
- Mastectomy, performed to alleviate chronic mastalgia, can paradoxically lead to the development of CRPS in the affected limb.
- The psychological element of CRPS may be exacerbated by the organ amputation.
- This suggests a complex interplay between surgical intervention, chronic pain, and neuropathic conditions.
Implications:
- The findings suggest that clinicians should consider CRPS when evaluating limb pain post-mastectomy, especially in patients with a history of chronic pain.
- Further research is warranted to understand the mechanisms linking mastectomy, chronic pain, and CRPS development.
- This underscores the importance of comprehensive pre-operative assessment and post-operative monitoring for potential CRPS in patients undergoing mastectomy for chronic pain conditions.