CHSU Discovery

Purpose of the Study: Complex regional pain syndrome (CRPS) is a severely disabling chronic pain condition that typically manifests in the upper or lower extremities following an injury, surgery, or stroke. CRPS is poorly understood, accordingly, there is no consensus on mainstay treatment. We, therefore, surveyed the recent clinical evidence assessing the therapeutic intervention of CRPS. 

Methods: Studies were identified from the following databases: MEDLINE, Embase, and the Cochrane Library using the terms, "Comple Regional Pain Syndrome" OR "algodystrophy" OR "shoulder-hand syndrome" OR "Sudeck syndrome" AND from January 2017 - May 2022.

Exclusion criteria included: animal studies, studies not available in English, preventative treatments, and studies involving minors. Randomized controlled trials only were included in the analysis. Following deduplication, title/abstract screening, and relevancy assessment, 421 initial records were reduced to 15 records.

Summary of Results: Treatments effectiveness was ranked based on success in mitigation of symptoms, starting with the most effective: 1) Internal (implanted) DRG stimulation (2 studies), 2) Bemer technology (2 studies), 3) Bisphosphonates (1 study), 4) Acupuncture (1 study), 5) Local anesthetic and SSRI (1 study), 6) Mycophenolate (1 study), 7) Thermofluid treatment (1 study), 8) External DRG stimulation (3 studies), 9) Visual-motor therapy (2 studies), 10) IVIG therapy (1 study).

Conclusions: Our survey of recent clinical evidence derived from RCT's identifies a number of potentially useful strategies for mitigating CRPS. The most successful approaches were internal DRG stimulation and Bemer technology, both being suitable candidates for treating patients non-repsnsive to "conventional" approaches.