Complex Regional Pain Syndrome, Dysfunctional Capillaries and Reduced Oxygenation

Dear Pain Matters blog readers,

Danish researchers just published a paper called:

‘Capillary dysfunction and impaired tissue oxygenation in complex regional pain syndrome: A hypothesis’

(in press still)

People with complex regional pain syndrome (CRPS) have severe pain in either a hand, arm, foot, or leg.  This may occur after physical trauma, crush injury, etc.  In the acute stage of CRPS, the autonomic nervous system appears completely ‘out-of-balance’, as evidenced by reddening, excess swelling and sweating of the affected limb region.

Danish researchers provide a hypothesis that localised hypoxia may lead to CRPS.  Prolonged hypoxia (significantly reduced oxygen saturation, oxygen deficiency, and blood flow disturbances) in the capillaries of the CRPS-affected limb may maintain CRPS.  Localized hypoxia can lead to small-fibre dysfunction (and even neuronal cell death), localised inflammation and, of course, severe pain.

Getting to the bottom of CRPS is necessary.  This will enable prompt diagnosis and proper treatment.

I recently co-wrote a 24-page Review Paper (published in 2011) that fits in very well with the Danish researchers’ hypothesis (see below).

Of course, the good news is that once the pain researchers can confirm the key mechanisms that underly CRPS, this will hopefully lead to prompt and effective treatments for CRPS patients (and hopefully, lead to recovery from CRPS).

Another point:

Recovery from CRPS is possible in some patients (with proper treatment).  This is evidenced by the very large Table that is included in our 24-page Review Paper that lists many studies that have successfully (or, at least, partly successfully) treated CRPS patients (more on this later).

Have a great day!

Sabina Walker

(1)  Østergaard et al; Capillary Dysfunction and Impaired Tissue Oxygenation in Complex Regional Pain Syndrome: A Hypothesis; Pain, Volume 155, Issue 10 , Pages 1922-1926, October 2014

(2) Sabina Walker and Professor Peter D. Drummond; Implications of a Local Overproduction of Tumor Necrosis Factor-α in Complex Regional Pain Syndrome; Pain Medicine, Volume 12, Issue 12, Pages 1784–1807, December 2011


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