MEDICINA SPORTIVA - Journal of Romanian Sports Medicine Society

Posttraumatic peripheral neuropathic pain and CRPS in the upper limb

The term of ”complex regional pain syndromes” (CRPS) was introduced by IASP (International Association for the Study of Pain) in 1994 and represents a group of algic disorders that may develop as a disproportional consequence of a minor trauma (contusion, fracture, postsurgical), usually in one extremity. There have been described 2 types of CRPS I, previously known as sympathetic dystrophy, develops following trauma with minor lesions and without obvious neurological impairment (with fractures, sprains, contusions or cutaneous lesions). CRPS II or causalgia has similar signs and symptoms and develops after trauma with important peripheral nerve injuries (10-12).
Neuropathic pain therapy is often inefficient regarding nociceptive pain. Knowledge of the patient's medical history related to neuropathic pain and using validated assessment tools are essential for differentiating neuropathic pain from nociceptive pain and to estimate the importance of the neuropathic component of pain from various pain syndromes. In 2007, International Society for The Study of Pain (IASP) proposed the following definition for neuropathic pain as ‘‘pain caused by a lesion or disease of the somatosensory system’’ (13). ”Diseases” are pathological processes such as inflammatory, autoimmune or dysfunction of ion channels. ”Lesions” are minor detectable lesions. Diseases and lesions of nervous system elements others than somatosensory component determine nociceptive pain. Spasticity and muscle pain related to motor system diseases and lesions are not being associated with neuropathic pain.