Case Series
Identification and Treatment of Complex Regional Pain Syndrome-Not Otherwise Specified (CRPS-NOS) with Peripheral Sympathetic Nerve Blockade: A Case Series
Carden E, Fanning MT, Sparley K and Horrigan J
1Southern California Academic Pain Management Institute/RSD Institute USA
2Tactical Sports Medicine Department, Southern California University of Health Science (SCU) USA
2Tactical Sports Medicine Department, Southern California University of Health Science (SCU) USA
*Corresponding author:Michael T. Fanning, Tactical Sports Medicine Department, Southern California University of Health Science (SCU) USA E-mail Id: MichaelFanning@scuhs.edu
Article Information:Submission: 14/05/2024; Accepted: 04/06/2024; Published: 06/06/2024
Copyright: © 2024 Carden E, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Introduction:Complex Regional Pain Syndrome (CRPS) is a pain condition that is often controversial in definition and treatment approach. While early identification of the disease process is important for treatment, current diagnostic criterium is particular on qualifying signs and symptoms. The restrictive nature the different consensus criterium may leave a patient without a diagnosis, and without effective treatment.
Methods:This case series details twelve patients that do not fall into the typical CRPS-I and II case presentation, diagnostic criteria and might not otherwise receive a CRPS diagnosis. These patients would more likely fall into a CRPS-NOS (not otherwise specified) diagnosis because they do not meet all of the criterium. Not considering CRPS-NOS as a diagnosis could ultimately lead to an inaccurate diagnosis, ineffective treatment, and poor long-term outcomes.
Results:During a fourteen-month period, patients that were experiencing multiple symptoms of CRPS were identified and referred to a CRPS specialist for confirmatory diagnosis and treatment. Each of the patients underwent a series of peripheral sympathetic nerve blocks which ceased, or at least significantly decreased, patient symptomatology.
Conclusion:This case series is a small sample size of patients that were successfully treated with a series of peripheral sympathetic nerve blocks and adjunct therapy for CRPS. CRPS is a difficult disease process to manage, often with invasive means of treatment such as sympathetic ganglion blockade, intrathecal pump, spinal cord stimulator and/or pharmacologics. Peripheral sympathetic nerve blockade can be a powerful diagnostic and treatment tool for patients suffering from CRPS.
Methods:This case series details twelve patients that do not fall into the typical CRPS-I and II case presentation, diagnostic criteria and might not otherwise receive a CRPS diagnosis. These patients would more likely fall into a CRPS-NOS (not otherwise specified) diagnosis because they do not meet all of the criterium. Not considering CRPS-NOS as a diagnosis could ultimately lead to an inaccurate diagnosis, ineffective treatment, and poor long-term outcomes.
Results:During a fourteen-month period, patients that were experiencing multiple symptoms of CRPS were identified and referred to a CRPS specialist for confirmatory diagnosis and treatment. Each of the patients underwent a series of peripheral sympathetic nerve blocks which ceased, or at least significantly decreased, patient symptomatology.
Conclusion:This case series is a small sample size of patients that were successfully treated with a series of peripheral sympathetic nerve blocks and adjunct therapy for CRPS. CRPS is a difficult disease process to manage, often with invasive means of treatment such as sympathetic ganglion blockade, intrathecal pump, spinal cord stimulator and/or pharmacologics. Peripheral sympathetic nerve blockade can be a powerful diagnostic and treatment tool for patients suffering from CRPS.
Keywords:Complex Regional Pain Syndrome; CRPS, neuropathic pain; Sympathetic nerve blockade; Pain management