• The Korean Journal of Pain
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• v.19 no.2
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• pp.152-158
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• 2006

Background: Complex regional pain syndrome (CRPS) is a painful, disabling disorder for which no proven treatment has been established. The purpose of this investigation was to assess the evidence of the efficacy of spinal cord stimulation (SCS) in the management of pain in CRPS patients. Methods: Between March 2004 and June 2006, 11 patients with CRPS were treated with SCS. The visual analog scale (VAS) score for pain (0⁣-10) and pain disability index (PDI) were obtained in all patients prior to treatment, and 1, 3 and 6 months post-implantation. Results: All 11 patients, 5 men and 6 women, with a median age and duration of CRPS of 44 years and 48.8 months, respectively, successfully received a lead implantation for SCS. The mean VAS pain score prior to the treatment was 85.5 out of 100 mm. After SCS implantation, the mean VAS pain scores were 49.5, 57.0 and 56.0 at 1, 3 and 6 months after the procedure, respectively. The mean pain score for allodynia was decreased by 50%, with a significant reduction of the PDI also observed after the treatment. Conclusions: Our current study suggests that SCS implantation is a safe and effective method in the management of CRPS patients.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.3
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• pp.678-684
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• 2009

It was reported that Dipsaci Radix has decrease pain effect on the Complex Region Pain Syndrome(CRPS). the CRPS was induced by unilateral loose occlusion in 4 part of the sciatic nerve of the rats. For the fingding significantly change on CRPS rats were divided into 4 different experimental groups. and each groups were induced CRPS. Experimental group I (control group; n=15), experimental group II (100 mg/kg Dipsaci Radix dieted rats; n=15), experimental group III (300 mg/kg Dipsaci Radix dieted rats; n=15), and experimental group IV(500 mg/kg Dipsaci Radix dieted rats; n=15). The study of Dipsaci Radix concentration was that foot withdrawal threshold to the thermal stimuli(Hot plate test), foot withdrawal threshold to the mechanical stimuli(von Frey's filament) and immunohistochemistry staining that were substance P. Hot plate test and von Frey Filament were increase in experimental group II, III, IV than group I, especially group III was most significantly change than group II and IV in post-hoc(Duncan's multiple range). and In immunohistochemistry observation; group I showed increase in the group II, III, IV. especially group III had the minimal level of the substance P expression while the experimental group II, III. These results suggested that the Dipsaci Radix dieted made the decrease of pain in CRPS.

• Journal of Korean Medicine Rehabilitation
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• v.21 no.3
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• pp.79-87
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• 2011

Objectives : The aim of this study was to observe the pain relief effect of moxibustion therapy in a patient with complex regional pain syndrome(CRPS). Methods : A male with type I CRPS, 48-year-old, who suffered from severe pain and paresthesia on his legs despite of treatments of oral medications and spinal cord stimulation was treated by indirect moxibustion following Korean medicine dianosis. Total 20 moxibustion treatments(once daily, 5 days a week, for 4 weeks) were given on the 4 acupoints(both side) where known to be effective fro the CRPS. Visual analogue scale(VAS), digital infrared thermal imaging(DITI), Beck depression index(BDI) were evaluated before and after the treatments. Pain relief, thermal changes on affected legs, and improvement of depression scale were observed after the treatments. Results : As for DITI, right thigh showed low temperature compared with left on before the treatments. While after the treatments, DITI showed similar temperature in both legs at discharge day. Conclusions : Though it is a case report, moxibustion therapy might have pain relief effect. Further rigorous case series and controlled trials are warranted.

• The Korean Journal of Pain
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• v.20 no.1
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• pp.66-70
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• 2007

No definitive etiology or risk factors have been identified that predispose individuals to developing complex regional pain syndrome (CRPS). We experienced two cases of CRPS developed after arterial and venous puncture which were done in regular medical work. A 35-years old female patient was suffered from pain and allodynia with swelling at right hand and wrist after radial artery puncture for monitoring of blood pressure during general anesthesia. A 24-years old male patient had pain and swelling with allodynia at the right fingers and arm after median cubital vein puncture for blood sampling. They did not have proper pain management as CRPS patients in the past weeks and months after their pain occurred. They were diagnosed as CRPS and started undergoing various interventional procedures, which led to improve their pain condition. Our cases suggest that CRPS could develop without any proved tissue damage in routine medical practice. In conclusion, health care workers should be educated in knowledge about the uncommon medical condition and proper consultation to pain specialist when it happens.

• The Korean Journal of Pain
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• v.20 no.1
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• pp.60-65
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• 2007

Complex Regional Pain Syndromes (CRPS) type I and type II are neuropathic pain conditions that are being increasingly recognized in children and adolescents. The special distinctive features of pediatric CRPS are the milder course, the better response to treatment and the higher recurrence rate than that of adults and the lower extremity is commonly affected. We report here on a case of pediatric CRPS that was derived from ankle trauma and long term splint application at the left ankle. The final diagnoses were CRPS type I in the right upper limb, CRPS type II in the left lower limb and unclassified neuropathy in the head, neck and precordium. The results of various treatments such as medication, physical therapy and nerve blocks, including lumbar sympathetic ganglion blocks, were not effective, so implantation of a spinal cord stimulator was performed. In order to control the pain in his left lower limb, one electrode tip was located at the 7th thoracic vertebral level and two electrode tips were located at the 7th and 2nd cervical vertebral levels for pain control in right upper limb, head, neck and right precordium. After the permanent insertion of the stimulator, the patient's pain was significantly resolved and his disabilities were restored without recurrence. The patient's pain worsened irregularly, which might have been caused by psychological stress. But the patient has been treated with medicine at our pain clinic and he is being followed up by a psychiatrist. (Korean J Pain 2007; 20: 60-65)

• The Korean Journal of Pain
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• v.32 no.1
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• pp.47-50
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• 2019

Background: It is uncommon for patients who have received a permanent implant to remove the spinal cord stimulator (SCS) after discontinuation of medication in complex regional pain syndrome (CRPS) due to their completely painless state. This study evaluated CRPS patients who successfully removed their SCSs. Methods: This 10-year retrospective study was performed on patients who had received the permanent implantation of an SCS and had removed it 6 months after discontinuation of stimulation, while halting all medications for neuropathic pain. Age, sex, duration of implantation, site and type of CRPS, and their return to work were compared between the removal and non-removal groups. Results: Five (12.5%, M/F = 4/1) of 40 patients (M/F = 33/7) successfully removed the permanent implant. The mean age was younger in the removal group ($27.2{\pm}6.4$ vs. $43.5{\pm}10.7$ years, P < 0.01). The mean duration of implantation in the removal group was $34.4{\pm}18.2$ months. Two of 15 patients (13.3%) and 3 of 25 patients (12%) who had upper and lower extremity pain, respectively, had removed the implant. The implants could be removed in 5 of 27 patients (18.5%) with CRPS type 1 (P < 0.01). All 5 patients (100%) who removed their SCS returned to work, while only 5 of 35 (14.3%) in the non-removal group did (P < 0.01). Conclusions: Even though this study had limited data, younger patients with CRPS type 1 could remove their SCSs within a 5-year period and return to work with complete pain relief.

• The Korean Journal of Pain
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• v.9 no.2
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• pp.426-429
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• 1996

Complex regional pain syndrome Type II(CRPS) can be diagnosed by new IASP criteria in 1994. Sympathetically maintained pain may or may not be present in a patient with complex regional pain syndrome. We experienced a CRPS Type II patient who has sympathetically maintained pain as a major painful nature developed after right multiple iliac bone fracture, right femoral artery thrombosis and lumbosacral plexus injury. Combination treatment with L2, L3, L4 sympathetic ganglion block and continuous lower thoracic epidural block for 30 days were tried to get long term effect. The patient had signs of successful. sympathetic denervation of the right foot. After that pain relief was sustained until three month later.

• The Korean Journal of Pain
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• v.30 no.3
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• pp.165-175
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• 2017

Nuclear medicine imaging is widely used in pain medicine. Low back pain is commonly encountered by physicians, with its prevalence from 49% to 70%. Computed tomography (CT) or magnetic resonance imaging (MRI) are usually used to evaluate the cause of low back pain, however, these findings from these scans could also be observed in asymptomatic patients. Bone scintigraphy has an additional value in patients with low back pain. Complex regional pain syndrome (CRPS) is defined as a painful disorder of the extremities, which is characterized by sensory, autonomic, vasomotor, and trophic disturbances. To assist the diagnosis of CRPS, three-phase bone scintigraphy is thought to be superior compared to other modalities, and could be used to rule out CRPS due to its high specificity. Studies regarding the effect of bone scintigraphy in patients with extremity pain have not been widely conducted. Ultrasound, CT and MRI are widely used imaging modalities for evaluating extremity pain. However, SPECT/CT has an additional role in assessing pain in the extremities.

• Journal of Korean Neurosurgical Society
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• v.59 no.5
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• pp.529-532
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• 2016

Complex regional pain syndrome (CRPS) type II is a syndrome that develops after nerve injury. Symptoms may be severe, and vary depending on the degree of sympathetic nerve involvement. As yet, there is no satisfactory treatment. We report the case of a female patient who had an L5 left transverse process fracture and an S2 body fracture, who developed symptoms of CRPS type II in her left lower leg that were aggravated during ambulation in spite of absolute bed rest for one month after the trauma. Several treatments, including bed rest, medication, and numerous nerve blocks were attempted, but the pain persisted. We finally tried injection of polydeoxyribonucleotide (PDRN) solution at the left L5 transverse process fracture site because we knew of the anti-inflammatory effect of PDRN. One day after this treatment, her symptoms had almost disappeared and three days later, she was discharged. We will also further discuss the possibility of using PDRN solution for the treatment of CRPS.

• Annals of Clinical Neurophysiology
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• v.9 no.1
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• pp.36-38
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• 2007

The pathomechanisms involved in both restless legs syndrome (RLS) and complex regional pain syndrome type I (CRPS I) are still controversial whether they are central or peripheral origins. We recently encountered a patient who had an unusual coexistence of both RLS and CRPS I, and both of which showed good responses to sympathetic block. These findings suggest the role of peripheral mechanisms, especially unmyelinated small autonomic fiber, in both RLS and CRPS I.