| Dokumentenart: | Artikel | ||||
|---|---|---|---|---|---|
| Titel eines Journals oder einer Zeitschrift: | Der Orthop�de | ||||
| Verlag: | SPRINGER | ||||
| Ort der Veröffentlichung: | NEW YORK | ||||
| Band: | 32 | ||||
| Nummer des Zeitschriftenheftes oder des Kapitels: | 5 | ||||
| Seitenbereich: | S. 418-431 | ||||
| Datum: | 2003 | ||||
| Institutionen: | Medizin > Lehrstuhl für Orthopädie | ||||
| Identifikationsnummer: |
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| Stichwörter / Keywords: | REFLEX SYMPATHETIC DYSTROPHY; MAINTAINED PAIN; CUTANEOUS HYPERALGESIA; NEUROPATHIC PAIN; EXERCISE THERAPY; GUANETHIDINE; BLOCKADE; PHENTOLAMINE; CAUSALGIA; RELIEF; CRPS type I; reflex sympathetic dystrophy (RSD); Sudeck's atrophy; diagnostics; therapy | ||||
| Dewey-Dezimal-Klassifikation: | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin | ||||
| Status: | Veröffentlicht | ||||
| Begutachtet: | Ja, diese Version wurde begutachtet | ||||
| An der Universität Regensburg entstanden: | Ja | ||||
| Dokumenten-ID: | 72300 |
Web of ScienceZusammenfassung
Complex regional pain syndrome type I (CRPS type 1) - formerly termed Sudeck's atrophy or reflex sympathetic dystrophy (RSD) - causes chronic, poorly controllable pain, autonomic, sensorimotor disorders, and serious trophic alterations in the later stages. It develops in the distal extremities mostly after minimal trauma or surgical intervention and rarely spontaneously. The severity of symptoms ...
Zusammenfassung
Complex regional pain syndrome type I (CRPS type 1) - formerly termed Sudeck's atrophy or reflex sympathetic dystrophy (RSD) - causes chronic, poorly controllable pain, autonomic, sensorimotor disorders, and serious trophic alterations in the later stages. It develops in the distal extremities mostly after minimal trauma or surgical intervention and rarely spontaneously. The severity of symptoms is disproportionate to the causative event. The latest scientific findings show that the previously called reflex sympathetic dystrophy (RSD), which was supposed to be a result of a hyperreactive autonomic nervous system, is a very complex syndrome that occurs on different integration levels of the nervous system. Sympathetically maintained pain (SMP) maybe facultatively characteristic, but is not to be misunderstood as an underlying mechanism. A neurogenic inflammation reaction has recently been discussed,just as had been postulated by Paul Sudeck long before. That was the reason why the International Association for the Study of Pain (ISAP) introduced the more descriptive term,complex regional pain syndrome" (CRPS) type I in 1994. Due to the complexity of the process necessitating qualified knowledge, it is important to immediately refer patients to a specialized pain OPD or clinic. The diagnosis of CRPS type I is based upon a carefully taken case history and a clinical examination by an experienced practitioner. Imaging diagnostic tools and laboratory findings are of no or only low predicative value. The question of whether SIVIP exists after diagnosing CRPS type I is eminent for therapy planning. Therefore, diagnostic regional anesthetics are still important in spite of their uncertain prognostic relevance. Physical therapy, occupational therapy, medical treatment, and psychotherapy play an important role in the primary treatment of CRPS type I as noninvasive procedures. Despite heavy criticism, invasive sympathetic block, subsequent to adequate diagnostics, is an important part of the therapeutic concept. A multimodal therapeutic concept, which includes all available possibilities, is absolutely necessary to avoid grave permanent disabilities caused by insufficient or failed therapy. Nevertheless, already established as well as new treatment modalities have to be critically observed by further randomized, prospective control trials.
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