Objectives: Proinflammatory mediators play an important role in the pathophysiology and development of complex regional pain syndrome type 1. Elevated cytokine production is suggested to increase nitric oxide production by activating the inducible nitric oxide synthase pathway. In this study, we aimed to determine the circulating nitric oxide concentrations in complex regional pain syndrome typ...

OBJECTIVE The aim of this systematic review was to merge and summarize the current evidence about prognostic factors relevant to the course of complex regional pain syndrome 1. METHODS MEDLINE, Embase, PsychINFO, CENTRAL and screened reference lists of included studies were searched for studies of parameters associated with the prognosis of the condition. Studies investigating stroke-related ...

BACKGROUND Quantitative sensory testing (QST), with thermal threshold determinations, is a routine part of the comprehensive clinical workup of patients suffering from chronic pain, especially those with Complex Regional Pain Syndrome seen at our outpatient pain clinic. This is done to quantitatively assess each patient's small fiber and sensory function in a controlled manner. Most patients ha...

Endogenous pain modulation may provide facilitation or inhibition of nociceptive input by three main mechanisms. Firstly, modification of synaptic strength in the spinal dorsal horn may increase or decrease transmission of nociceptive signals to the brain. Secondly, local dorsal horn interneurons provide both feed-forward and feed-back modulation to spinothalamic and spinobulbar projection neur...

With colleagues, we have set up CRPS Network UK to improve clinical care and promote research into this condition. Our members have been involved in developing recent evidence based national guidelines. We are disappointed that Bass writes a provocative but poorly argued case that CRPS is over diagnosed and has psychological stress as the main trigger and thus is a ‘medicalised’ phenomena[i]. W...

Reflex Sympathetic Dystrophy is a dysfunctional pain response to a noxious stimulus. It is characterized by pain out of proportion to the inciting event, which may be quite insignificant but can be severe. In its earliest stages reflex sympathetic dystrophy is responsive to sympathetic blockade, pharmacologic agents, other modalities, and physical therapy. Early recognition and treatment is cri...

Complex regional pain syndrome describes a constellation of symptoms that may involve the sympathetic nervous system. Emerging consensus recommends early intervention with spinal cord stimulation to facilitate physical therapy. Isolated case reports suggest this may be an effective treatment. Ten consecutive active duty United States military personnel with newly diagnosed complex regional pain...

OBJECTIVE To investigate whether pain-related fears are mediators for reducing disability and pain in patients with Complex Regional Pain Syndrome type 1 when treating with Pain Exposure Physical Therapy. DESIGN An explorative secondary analysis of a randomised controlled trial. PARTICIPANTS Fifty-six patients with Complex Regional Pain Syndrome type 1. INTERVENTIONS The experimental grou...