Complex regional pain syndrome and chiropractic

Background: Complex regional pain syn dromes (CRPS) represent curious and d ifficult syndromes for both patient and clinician. CRPS presents as a triad of signs and symptoms. usually after a seemingly trivial injury to a perip heral joint or appendage. The clinical triad includes severe paint vasomoto r changes in and around the affected area, and trophic changes in the affec ted,limb. Many of the acute symptoms are similar to chose seen after many a cute injuries, which makes an early diagnosis often times difficult. Curren t treatment protocols revolve around aggressive physical therapy plus pharm acologic interventions aimed at limiting sympathetic nervous system activit y. Objective: To review the literature on CRPS regarding symptoms, diagnosis, treatment, and causal mechanisms and to discuss alternative treatment appro aches and the possible role of chiropractic care in patient rehabilitation. Data Sources: Texts, review articles, and randomized clinical trials invest igating treatments, causes, and epidemiology. Conclusions: Recent research calls into question the predominant theories t hat view excessive sympathetic nervous system activity as the cause of CRPS . No evidence of an increase in sympathetic nervous system activity has bee n found, and new theories suggest that an increase in the sensitivity of ne urotransmitter receptors may be the cause of CRPS. Alternatively: other res earch has suggested that a local inflammatory process may in fact cause CRP S. although no research has been completed examining the role of chiropract ic care in the treatment of CRPS, there is reason to believe that spinal ma nipulation may be beneficial to patients with CRPS.