Peripheral Neuromodulation for Treatment of Upper Extremity Complex Regional Pain Syndrome Following Peripherally...

Complex regional pain syndrome (CRPS) is a chronic pain condition that typically affects distal extremities after an injury or noxious event, with symptoms disproportionate to the primary insult. We present the first successful use of a temporary peripheral nerve stimulator (PNS) followed by a permanent PNS system to treat CRPS Type 2 after failed responses to pharmacotherapies, trigger point injections, cervical epidural injections, and sympathetic nerve blocks.

An 81-year-old patient developed CRPS Type 2 following a left antecubital peripherally inserted central catheter placement with left-hand paresthesia, edema, weakness, and skin color and temperature asymmetry. He achieved near-complete resolution of symptoms approximately 4 months after permanent PNS placement.

This case underscores the morbidity associated with iatrogenic complications, the challenges of managing CRPS when conventional treatments prove insufficient, and the necessity for further research to assess the effectiveness of PNS in improving both function and pain relief for CRPS patients.