Complex regional pain syndrome (CRPS) is an uncommon form of chronic pain lasting greater than six months, that usually affects one limb (arm, leg, or foot). CRPS typically develops after an injury, cardiovascular event such as a stroke or heart attack, or as a complication of surgery. CRPS is believed to be caused by damage to, or malfunction, of both the peripheral and central nervous system, leading to severe, chronic, neuroinflammation. Women are affected more commonly than men, with a peak incidence occurring in middle age, being rare in children and the elderly.
Symptoms can include continuous burning or throbbing pain in the affected limb, along with sensitivity to touch and cold. Changes to skin temperature and color, along with swelling are common. Additional symptoms often include joint stiffness, as well as muscle spasm and weakness.
A diagnosis of CRPS can be suspected if there is an obvious precipitating event such as an injury or surgery, but often it can take a significant amount of time and testing to rule out other explanations such as Lyme disease and arthritis.
The prognosis of CRPS is highly variable with many cases self-resolving. Younger patients tend to have better overall outcomes. In some patients, however, the symptoms can be persistent, representing a difficult condition to successfully treat. Traditional treatment options include primarily rehabilitation and physical therapy. Medications are aimed at symptom relief. There are currently no medications approved by the FDA specifically for the treatment of CRPS.
The study featured below describes the successful use of LDN in the treatment of CRPS in three patients with long-standing (>3 years) CRPS. The first two case studies involve patients with intractable CRPS of multiple extremities whose daily functioning such as walking were severely impacted.
After two months of LDN therapy, both patients were able to significantly reduce the use of their pain medications and had dramatic improvement of their overall symptoms, including one patient being able to stop the use of their walking cane. The second patient was able to undergo surgery for their dystonic foot with no post-operative exacerbation of their symptoms, and ultimately achieved complete remission of their symptoms. This may represent a significant advance in being able to conduct needed surgeries without the traditional concerns for flaring of CRPS symptoms.
A third patient suffering from CRPS of the right leg, as well as Ehlers-Danlos, and SIBO, had failed 8 years of attempts to control her pain through traditional protocols. LDN was introduced as an additional therapy ultimately resulting in the patient achieving complete remission of her symptoms.
The authors conclude that given the success of LDN in the treatment of the symptoms of CRPS in these patients who had failed traditional therapies, that LDN should be considered as an additional treatment option for patients suffering from Complex Regional Pain Syndrome (CRPS).
Written by David Yeazel, MS, MPH