PDF(Pubmed)
Abstract：
Complex regional pain syndrome (CRPS) is a debilitating chronic pain condition that, although exceedingly rare, carries a significant burden for the affected patient population. The complex and ambiguous pathophysiology of this condition further complicates clinical management and therapeutic interventions. Furthermore, being a diagnosis of exclusion requires a diligent workup to ensure an accurate diagnosis and subsequent targeted management. The development of the Budapest diagnostic criteria helped to consolidate existing definitions of CRPS but extensive work remains in identifying the underlying pathways. Currently, two distinct types are identified by the presence (CRPS type 1) or absence (CRPS type 2) of neuronal injury. Current management directed at this disease is broad and growing, ranging from non-invasive modalities such as physical and psychological therapy to more invasive techniques such as dorsal root ganglion stimulation and potentially amputation. Ideal therapeutic interventions are multimodal in nature to address the likely multifactorial pathological development of CRPS. Regardless, a significant need remains for continued studies to elucidate the pathways involved in developing CRPS as well as more robust clinical trials for various treatment modalities.
Complex regional pain syndrome (CRPS) is a debilitating and complex condition that places a significant physical, psychological and emotional burden upon afflicted patients necessitating multi-modal approaches to treatment.The development of the Budapest criteria provided a robust and well-tested set of diagnostic criteria to aid clinicians in the diagnosis of CRPS.The pathophysiology of CRPS has been challenging to elucidate with numerous proposed mechanisms, altogether suggesting a multi-factorial process is involved in the development of this condition.Non-invasive treatments for CRPS are essential in addressing the physical limitations this disease can cause as well as addressing the significant psychological burden that involves increased incidence of depression and suicidal ideation.Invasive treatments offer promising results, especially when considering dorsal root ganglion stimulation; however, the need for more robust clinical trials remains, especially when considering a small portion of patients who have refractory CRPS resort to amputation to control their pain symptoms.
Complex regional pain syndrome (CRPS) is a debilitating and complex condition that places a significant physical, psychological and emotional burden upon afflicted patients necessitating multi-modal approaches to treatment.The development of the Budapest criteria provided a robust and well-tested set of diagnostic criteria to aid clinicians in the diagnosis of CRPS.The pathophysiology of CRPS has been challenging to elucidate with numerous proposed mechanisms, altogether suggesting a multi-factorial process is involved in the development of this condition.Non-invasive treatments for CRPS are essential in addressing the physical limitations this disease can cause as well as addressing the significant psychological burden that involves increased incidence of depression and suicidal ideation.Invasive treatments offer promising results, especially when considering dorsal root ganglion stimulation; however, the need for more robust clinical trials remains, especially when considering a small portion of patients who have refractory CRPS resort to amputation to control their pain symptoms.
摘要：
复杂区域疼痛综合征(CRPS)是一种使人衰弱的慢性疼痛病症,虽然极为罕见,对受影响的患者群体带来了巨大的负担。这种情况的复杂和模糊的病理生理学进一步使临床管理和治疗干预复杂化。此外，作为排除的诊断需要勤奋的检查，以确保准确的诊断和随后的针对性管理。布达佩斯诊断标准的制定有助于巩固CRPS的现有定义，但在确定潜在途径方面仍有大量工作。目前,通过神经元损伤的存在（CRPS1型）或不存在（CRPS2型）鉴定出两种不同的类型。目前针对这种疾病的管理范围广泛且不断增长，从物理和心理治疗等非侵入性方式到更侵入性的技术，如背根神经节刺激和潜在的截肢。理想的治疗干预措施本质上是多模式的，以解决CRPS可能的多因素病理发展。无论如何,对于继续研究以阐明CRPS发展过程中涉及的通路,以及对于各种治疗方式进行更有力的临床试验,仍存在着巨大的需求.
复杂区域疼痛综合征（CRPS）是一种使人衰弱且复杂的疾病，患者的心理和情感负担需要多模式的治疗方法。布达佩斯标准的制定提供了一套可靠且经过良好测试的诊断标准，以帮助临床医生诊断CRPS。CRPS的病理生理学一直是具有挑战性的阐明与许多提出的机制，这表明这种情况的发展涉及一个多因素的过程。CRPS的非侵入性治疗对于解决这种疾病可能引起的身体限制以及解决涉及抑郁症和自杀意念发生率增加的重大心理负担至关重要。侵入性治疗提供了有希望的结果，尤其是在考虑背根神经节刺激时；然而，仍然需要更强有力的临床试验，尤其是考虑到一小部分患有难治性CRPS的患者采取截肢手术来控制疼痛症状时.
复杂区域疼痛综合征（CRPS）是一种使人衰弱且复杂的疾病，患者的心理和情感负担需要多模式的治疗方法。布达佩斯标准的制定提供了一套可靠且经过良好测试的诊断标准，以帮助临床医生诊断CRPS。CRPS的病理生理学一直是具有挑战性的阐明与许多提出的机制，这表明这种情况的发展涉及一个多因素的过程。CRPS的非侵入性治疗对于解决这种疾病可能引起的身体限制以及解决涉及抑郁症和自杀意念发生率增加的重大心理负担至关重要。侵入性治疗提供了有希望的结果，尤其是在考虑背根神经节刺激时；然而，仍然需要更强有力的临床试验，尤其是考虑到一小部分患有难治性CRPS的患者采取截肢手术来控制疼痛症状时.
