Complex Regional Pain Syndrome in Children: a Multidisciplinary Approach and Invasive Techniques for the Management of Nonresponders

Pain Pract. 2015 Nov;15(8):E81-9. doi: 10.1111/papr.12317. Epub 2015 Jun 11.

Abstract

Complex regional pain syndrome (CRPS) is multifactorial condition with complex pathogenesis characterized by spontaneous or stimulus-induced pain that is disproportionate to the inciting event. It is also commonly accompanied by a myriad of autonomic and motor disturbances in highly variable combinations. This condition has been underreported in children until recently. Consequently, the management of CRPS in the pediatric population presents an even greater challenge than in adults, partly because there is a lack of clinical data concerning the efficacy of the diverse treatment methods available, and partly because successful treatment of CRPS involves a multidisciplinary approach. In this retrospective case series, a multidisciplinary management plan is presented in 10 children for whom the standard noninvasive treatment was unsuccessful. Within this management plan, novel drugs were included such as the capsaicin 8% patch, in addition to invasive techniques in patients who did not respond to noninvasive therapies.

Keywords: CRPS; capsaicin; clinical case series; complex regional pain syndrome; epidural analgesia; infusion pumps, implantable; multidisciplinary pain management; neuropathic pain; pediatric pain.

MeSH terms

  • Child
  • Combined Modality Therapy
  • Complex Regional Pain Syndromes / therapy*
  • Female
  • Humans
  • Male
  • Pain Management / methods*
  • Retrospective Studies