Spinal cord stimulation in complex regional pain syndrome type I of less than 12-month duration

Neuromodulation : Journal of the International Neuromodulation Society
Frank van EijsMaarten van Kleef

Abstract

Complex regional pain syndrome type 1 (CRPS-1) has a 31% probability of becoming chronic. The early use of spinal cord stimulation (SCS) has been recommended as a strategy to prevent chronicity and functional impairment. In a prospective study, we treated 74 CRPS-1 patients with a mean disease duration of 17 weeks with standard therapy consisting of physical therapy, topical dimethyl sulfoxide, analgesics, transcutaneous stimulation, and sympathetic blockade. Patients who did not respond to standard therapy were offered a treatment with SCS. In these patients, we investigated the impact on pain, quality of life, and function. Out of these 74 patients treated with standard therapy, six patients were included for early SCS treatment. The overall mean pain relief after one year was 35%. The mental component of the Short Form 36 improved; however, there was no effect on the physical component. None of the SCS treated patients showed a clear improvement in functional outcome. We conclude that the feasibility of performing a randomized controlled trial on early SCS therapy in CRPS-1 is low because of the good disease improvement with standard therapy in the first year after onset. This study raises questions about the need to use SCS...Continue Reading

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Citations

Dec 19, 2012·Current Pain and Headache Reports·Claudia M CampbellRobert R Edwards
Dec 5, 2012·Neuromodulation : Journal of the International Neuromodulation Society·Robert M Levy
Feb 7, 2014·Current Pain and Headache Reports·Kari A Stephens, Alison Ward
Feb 1, 2013·Neuromodulation : Journal of the International Neuromodulation Society·José W GeurtsMaarten van Kleef
Jan 9, 2013·Neuromodulation : Journal of the International Neuromodulation Society·Rafael Justiz, Ishmael Bentley
Jan 24, 2014·Pain Practice : the Official Journal of World Institute of Pain·Jean-Pierre Van BuytenFrank Huygen
Apr 24, 2015·Acta Anaesthesiologica Scandinavica·M BussaS Rinaldi
Jul 3, 2016·Pain Practice : the Official Journal of World Institute of Pain·Umberto RaucciElena Conicella
Oct 16, 2016·Pain Practice : the Official Journal of World Institute of Pain·Ognjen VisnjevacNagy A Mekhail
Nov 29, 2016·PM & R : the Journal of Injury, Function, and Rehabilitation·Martino BussaSimona Rinaldi
Feb 9, 2020·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Timothy R DeerNagy Mekhail

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