Open AccessNerve Injuries and the Fixed Dystonias of CRPS
Author(s) -
COOPER MARK S.
Publication year - 2011
Publication title -
pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 97
eISSN - 1526-4637
pISSN - 1526-2375
DOI - 10.1111/j.1526-4637.2011.01082.x
Subject(s) - medicine , complex regional pain syndrome , dystonia , etiology , anesthesia , neuropathic pain , physical medicine and rehabilitation , psychiatry
Nerve injury is a known precipitant of complex regional pain syndrome (CRPS). However, is nerve injury a primary cause of CRPS dystonia? In 2009, Oaklander and her colleagues [1] reviewed peripheral aspects of CRPS, asking whether diverse symptoms of this neuropathic pain disorder are linked to small-fiber neuropathies. These authors also described a possible role for large-fiber neuropathies in the etiology of CRPS-fixed dystonias. This hypothesis adds a valuable new perspective to one of the most controversial topics in neurology: the fixed dystonias of CRPS.During, and after, the American Civil War, Dr. Silas Weir Mitchell described both intense burning pain (causalgia) and fixed dystonias in a subset of wounded Union soldiers, as well as civilians, who had suffered nerve injuries [2]. In a number of these patients, remission of the CRPS comorbidities occurred within days to weeks after therapies were initiated (e.g., passive movement and splinting of inflamed/immobilized joints, massage and electrical stimulation of contracted muscles, and chemical blistering of causalgic skin). The rapid onset and rapid remission of …