• Clinical Pain
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• 제18권2호
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• pp.133-137
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• 2019

The long-term prognosis of complex regional pain syndrome is difficult to predict because of its unclear pathophysiology. The syndrome can spontaneously spread to other regions in the body. We report a case in which a complex regional pain syndrome that occurred in a 75-year-old male patient after a stroke spread to the opposite side.

• The Korean Journal of Pain
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• 제14권1호
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• pp.118-122
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• 2001

Complex regional pain syndrome type I of vascular origin is difficult to detect unless the classic symptoms and signs exist and/or overt extremity trauma has precipitated the pain. The diagnosis is confirmed by relief of pain following a sympathetic nerve blockade. A 36-year-old woman with arterial occlusive disease of the right lower extremity presented with burning pain and hyperesthesia after sprain had occurred which was accompanied by motor weakness of right ankle. A lumbar sympathetic ganglion blockade with 2% lidocaine 10 ml and triamcinolone 80 mg produced prompt improvement of the pain and motion.

• The Korean Journal of Pain
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• 제23권1호
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• pp.70-73
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• 2010

Complex regional pain syndrome (CRPS) is a painful and disabling disorder that can affect one or more extremities. Unfortunately, the knowledge concerning its natural history and mechanism is very limited and many current rationales in treatment of CRPS are mainly dependent on efficacy originated in other common conditions of neuropathic pain. Therefore, in this study, we present a case using a total spinal block (TSB) for the refractory pain management of a 16-year-old male CRPS patient, who suffered from constant stabbing and squeezing pain, with severe touch allodynia in the left upper extremity following an operation of chondroblastoma. After the TSB, the patient’s continuous and spontaneous pain became mild and the allodynia disappeared and maintained decreased for 1 month.

• Journal of Acupuncture Research
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• 제39권3호
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• pp.234-238
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• 2022

A 53-year-old male who had received surgery on his right ankle joint 10 years previously was diagnosed with Complex Regional Pain Syndrome the following year. Despite various treatments (sympathetic nerve-block medication, pain relievers, corticosteroids, nerve blocks, and transcutaneous electrical nerve stimulation) over the years there was no improvement in his symptoms. Recently the patient was admitted to a Korean medicine hospital where he received treatment (acupuncture, pharmacopuncture, and herbal treatment) and his symptoms gradually showed improvement. The patient was concurrently on psychiatric medicine, antihistamine medication, and opioids for pain (when necessary). A decrease in numeric rating scale, Oswestry disability index scores, and an increase in the Korean version of the 5-level EuroQol-5 dimension score showed symptom improvement within 36 days. This study suggests complex Korean medicine treatment for Complex Regional Pain Syndrome may result in a reduction in pain and improved quality of life.

• The Korean Journal of Pain
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• 제22권2호
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• pp.146-150
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• 2009

Background: A skin temperature difference is one of the variables used in the diagnosis of complex regional pain syndrome. However, there have been no reports as to whether the real (${\Delta}T$) or absolute value ($|{\Delta}T|$) of skin temperature differences should be used in the diagnosis of complex regional pain syndrome. This study was conducted to compare the diagnostic validity of ${\Delta}T$ with $|{\Delta}T|$ for complex regional pain syndrome using receiver operating characteristic curves (ROC). Methods: Infrared thermographic images were obtained from the 144 patients who were suspected to have CRPS in a unilateral limb. After ${\Delta}T$ and $|{\Delta}T|$ calculation from the thermographic image, ROCs of ${\Delta}T$ and $|{\Delta}T|$ were developed, and the areas under the curve (AUC) for the ROC curves were compared. Results: AUCs of ${\Delta}T$ and $|{\Delta}T|$ were 0.520 and 0.746 respectively, this difference was statistically significant (P < 0.001). Conclusions: Absolute skin temperature difference shows greater validity in the diagnosis of CRPS than ${\Delta}T$. Therefore, $|{\Delta}T|$ is more useful when comparing the skin temperature of CRPS patients.

• 척추신경추나의학회지
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• 제8권1호
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• pp.63-73
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• 2013

한랭자극에 취약한 복합부위통증증후군 환자 1례를 대상으로 한방치료 및 천수근약침 치료를 시행한 결과 환자의 주소증 및 NRS, ODI, MMT 결과상 호전이 있었음을 확인하였다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권5호
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• pp.295-300
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• 2019

Complex regional pain syndrome (CRPS) is rare, characterized by pain from diverse causes, and presents as extreme pain even with minor irritation. General anesthesia may be required for dental treatment because the pain may not be controlled with local anesthesia. However, treatment under general anesthesia is also challenging. A 38-year-old woman with CRPS arrived for outpatient dental treatment under general anesthesia. At the fourth general anesthesia induction, she experienced severe pain resulting from her right toe touching the dental chair. Anesthesia was induced to calm her and continue the treatment. After 55 minutes of general anesthesia, the patient still complained of extreme toe pain. Subsequently, two administrations for intravenous sedation were performed, and discharge was possible in the recovery room approximately 5 h after the pain onset. The pain was not located at the dental treatment site. Although the major factor causing pain relief was unknown, ketamine may have played a role.

• Journal of Acupuncture Research
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• 제29권4호
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• pp.93-97
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• 2012

Complex regional pain syndrome type 1(CRPS 1) is a neuropathic pain disorder that accompanies severe pain and motor deficit as well as changes in the skin in the extremities. The pathophysiology of CRPS 1 is still not exactly elucidated. However, the general consensus of involvement of inflammatory mediators in the development of CRPS 1 is amply made. On the basis that placental extract successfully inhibited the production of inflammatory cytokines and mediators in several experimental models, we have tried a long-term weekly injection of placental extract into acupuncture points to a CRPS 1 patient suffering pain and immobilization of shoulder joint. The results say that placental extract effectively resolved pain, restored skin color and improved immobilization of shoulder joint in the CRPS 1 patient.

• The Korean Journal of Pain
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• 제34권1호
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• pp.94-105
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• 2021

Background: Many patients with complex regional pain syndrome (CRPS) have been known to be at risk of suicide, due to severe pain and its comorbid conditions. The risk of suicide may be associated with affective instability, which is an indicator of emotional dysregulation. Particularly, unstable shifts in negative emotions are difficult to cope with, which may result in individuals feeling uncontrollable, hopeless, and entrapped. This study aimed to examine the role of affective instability in the relationship between pain intensity and suicide risk (suicidal ideation and impulsivity) in patients with CRPS, by employing a daily diary. Methods: Twenty-three patients registered at the CRPS Association in Korea were asked to complete a day-to-day routine for 15 days, followed by a diary composed of pain intensity, suicidal ideation, impulsivity, and positive and negative affects. Results: Results showed that the interactions between negative affective instability and daily pain intensity were statistically significant on daily suicidal ideation (coefficient = 0.41, t (21) = 2.56, P < 0.050) and daily impulsiveness (coefficient = 1.20, t (19) = 3.35, P < 0.010). However, those between positive affective instability and daily pain intensity were not. Conclusions: This study is the first attempt to investigate the role of affective instability on the relationship between daily pain intensity and daily suicide risk in patients with CRPS. Our findings suggest that health professionals pay considerable attention to the instability of negative affects when assessing and managing patients with CRPS at risk of suicide.

• The Korean Journal of Pain
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• 제27권1호
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• pp.68-71
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• 2014

The occurrence of CRPS after a snake bite was very rare, only two cases were reported worldwide. Here we report a case that the 44-year-old female patient bitten by snakes CRPS type 1 was treated consecutive intravenous regional block, lumbar sympathectomy and antiepileptic drug therapy, also discuss the possible pathophysiology.