Patient Information Resources

Centre for Orthopaedics
Suite 10-33/34/35 Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road
Singapore, 329563, Singapore
Ph: (65) 6684 5828
Fax: (65) 6684 5829

Child Orthopedics
Pain Management
Spine - Cervical
Spine - General
Spine - Lumbar
Spine - Thoracic

View Web RX

« Back

I have been finally diagnosed (after months of pain) with complex regional pain syndrome. No one really knows what caused it, but I guess maybe a small car accident (just a fender bender) I had this past summer might be it. The doctor is recommending a more powerful antiinflammatory. I've been taking ibuprofen forever. How is something else going to work any better?

Complex regional pain syndrome CRPS is a very painful disorder that affects people after a seemingly minor injury sometimes. The problem is not understood very well. Doctors don't know what causes it or why it happens. That makes CRPS a difficult condition to treat effectively. In recent years, anti-inflammatory medications have been used with mixed results. But the fact that this approach works for some patients makes it worth investigating further. If CRPS is an exaggerated response of the immune system to tissue injury, then inflammatory messengers and inflammatory cells must be part of the signaling system that bring on the painful symptoms. People with complex regional pain syndrome (CRPS) often experience intense pain, swelling and skin changes (color, texture, hair growth, temperature). The net result is a loss of motion and function along with reduced quality of life. Scientists hope that by cutting off immune cells like cytokines, chemokines, and mast cells, it might be possible to stop (or even prevent) these disabling symptoms. A recent report from The Netherlands published results on two types of antiinflammatory medications used with complex regional pain syndrome: corticosteroids and free radical scavengers. These drugs are much more powerful than regular ibuprofen. Corticosteroids used often include oral prednisolone and piroxicam (CNT). Free radical scavengers include DMSO, vitamin C, and Mannitol. Free radicals are unstable oxygen atoms that form when they lose an electron. Electrons like to be in pairs. The loss of one electron literally puts the atom into orbit. It becomes a scavenger looking for another oxygen atom so that it can rob or steal the necessary electron. The result is a cascade of damage to the cells as new radicals are formed in order to salvage the damaged oxygen atoms. Compounds like DMSO, vitamin C, and Mannitol work by getting rid of free radicals. Inflammatory reactions are reduced by eliminating free radicals. The end-result is to limit the amount of tissue damage that occurs from inflammation. In some clinics, corticosteroids and free radical scavengers are used together. Both classes of drugs (corticosteroids and free radical scavengers) have been shown to provide relief from painful symptoms. Patients receiving either medication show significant improvements. This tells us that it is possible to stop the inflammatory process in different ways (turning off inflammatory cells, getting rid of damaging free radicals). Matching the most helpful drug to each individual patient is the next challenge. If you begin a course of medications that do not give you the results you are hoping for, don't hesitate to go back to the prescribing physician. You may need a change in dosage or even a different drug.


« Back

*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

All content provided by eORTHOPOD® is a registered trademark of Mosaic Medical Group, L.L.C.. Content is the sole property of Mosaic Medical Group, LLC and used herein by permission.