Complex regional pain syndrome integrates sensory, motor and autonomic-trophic disorders, which have been previously described under the name "reflex sympathetic dystrophy" and "causalgia."
Complex regional pain syndrome is terminated after sympathetic blockade. Recently, however, it became clear that a large number of patients with "sympathetic caused pain" have "sympathetic independent pain" that prompted the experts of the International Association for Pain Study in classification of pain syndromes in 1994 to propose the term "complex regional pain syndrome.
Isolated complex regional pain syndrome is of 2 types - I and II. Complex regional pain syndrome type I usually develops after micro trauma or exposure in the form of prolonged immobilization (applying splints, plaster, concussion, soft tissue injury in the extremities etc.) unlimited damage to a peripheral nerve, and obviously disproportionate consequences of this impact.
It is believed that the type II complex regional pain syndrome is diagnosed when damaged peripheral nerve or one of its branches, which is often accompanied by the phenomena of causalgia.
The main manifestations of complex regional pain syndrome and the underlying diagnostic criteria are –pain syndrome develops in one limb (usually in the distal parts): the sensation of burning, aching or bursting pain in combination with sensory disorders (hypo-or anaesthesia, hyperpathia , allodynia, i.e. the stimulatory perception of any modalities like pain), vegetative-trophic disorders (swelling, discoloration of the skin, changes in local skin temperature, impaired sweating, change in the rate of hair and nail growth, local osteoporosis) and movement disorders in the form of varying degree of paresis.
Clinical manifestations of complex regional pain syndrome
Pain in complex regional pain syndrome is by nature neuropathic, which is represented by two main components: spontaneous (stimulus independent) and evoked pain (stimulus dependent) hyperalgesia.
Intraosseous blockade can reduce the pain, the clinical manifestations of complex regional pain symptoms and improve the quality of life for patients.
Photos of intraosseous blockades used to treat complex regional pain syndrome: