Role of biphosphonates and lymphatic drainage type Leduc in the complex regional pain syndrome (shoulder-hand syndrome)

Pain Med. 2009 Jan;10(1):179-85. doi: 10.1111/j.1526-4637.2008.00539.x.

Abstract

Background: Complex regional pain syndrome (CRPS) is a clinical entity that has been termed in numerous ways in the last years. Clinically, CRPS describes an array of painful conditions that are characterized by a continuing (spontaneous and/or evoked) regional pain that is seemingly disproportionate in time or degree to the usual course of any known trauma or other lesion. The pain is regional and usually has a distal predominance of abnormal sensory, motor, sudomotor, vasomotor, and/or trophic findings.

Design: Case report.

Setting: University Medical Center. Patients. In this report, we described the case of a 68-year-old hemiplegic female affected by cerebrovascular accident that presented a clinical case of CRPS shoulder-hand syndrome (CRPS-SHS) at the right hand after a hemorrhagic stroke.

Interventions: This report evaluated the effects of biphosphonates and lymphatic drainage type Leduc in CRPS-SHS.

Outcome measures: The pain level of the patients was measured with the visual analog scale. A scoring system for the clinical severity of CRPS-SHS, laboratory tests, and X-ray films were also performed.

Results: We reported in this patient a great improvement of pain and edema of the right hand, with a significant reduction of bone demineralization.

Conclusions: This combined treatment may be a viable alternative for this syndrome; however, further investigation is needed to determine its reproducibility in large case series.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Bone Density Conservation Agents / therapeutic use*
  • Combined Modality Therapy
  • Complex Regional Pain Syndromes / diagnosis
  • Complex Regional Pain Syndromes / drug therapy*
  • Complex Regional Pain Syndromes / etiology
  • Diphosphonates / therapeutic use*
  • Female
  • Humans
  • Musculoskeletal Manipulations*
  • Pain / drug therapy
  • Pain / etiology
  • Pain Measurement
  • Reflex Sympathetic Dystrophy / diagnosis
  • Reflex Sympathetic Dystrophy / drug therapy*
  • Reflex Sympathetic Dystrophy / etiology
  • Stroke / complications
  • Treatment Outcome

Substances

  • Bone Density Conservation Agents
  • Diphosphonates