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运动员中的复杂性区域疼痛综合征:范围综述。

Complex Regional Pain Syndrome in Athletes: Scoping Review.

机构信息

Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.

出版信息

Medicina (Kaunas). 2021 Nov 17;57(11):1262. doi: 10.3390/medicina57111262.

Abstract

Complex regional pain syndrome (CRPS) is a chronic condition characterized by disproportionate regional pain, usually affecting distal limbs, that follows trauma or surgery. Athletes may develop CRPS because of exposure to traumatic or overuse injuries. The aim of the present study is to review the available literature about CRPS type 1 in athletes. : We searched two online databases (PubMed and Web of Science), selecting papers aiming at investigating CRPS type 1 (algodystrophy) in athletes. The analysis of databases was made considering original articles published until 30 June 2021, written in English. Fifteen papers (12 case reports, 3 case series) were selected for a total of 20 clinical cases (15 females, 5 males), aged between 10 and 46 years (mean age 18.4 ± 9.8 standard deviation years). Patients included practiced different types of sport (soccer, athletics, gymnastics, basketball). The most involved anatomical sites were lower limbs, and time to diagnosis ranged from 2 days to 4 years. The most used treatments were pharmacological and physical therapies, but sometimes invasive approaches, as regional nerve, or lumbar sympathetic blocks, were provided. The main assessed outcomes were return to activity and pain. : Our review suggests a higher prevalence of CRPS type 1 in younger people and in lower limbs than in general population but confirms the higher prevalence in females. However, the number of studies addressing CRPS in athletes is limited, as well as the number of involved patients, considering that only few and heterogeneous case reports were published about this topic. Moreover, the high prevalence of old studies (only 5 available studies in the last 10 years) might have influenced the choice of both assessment tools and management strategies. Despite these limitations, athletes showing disproportionate pain after sport-related injury should be promptly evaluated and treated through a multidimensional approach to avoid long-term consequences of algodystrophy.

摘要

复杂性区域疼痛综合征(CRPS)是一种以不成比例的区域性疼痛为特征的慢性疾病,通常影响远端肢体,继发于创伤或手术后。运动员可能因接触创伤性或过度使用性损伤而发展为 CRPS。本研究旨在回顾关于运动员 1 型 CRPS 的现有文献。

我们在两个在线数据库(PubMed 和 Web of Science)中进行了搜索,选择了旨在调查运动员 1 型 CRPS(痛性营养不良)的论文。对数据库的分析考虑了截至 2021 年 6 月 30 日发表的英文原创文章。共选择了 15 篇论文(12 篇病例报告,3 篇病例系列),共计 20 个临床病例(15 名女性,5 名男性),年龄在 10 至 46 岁之间(平均年龄 18.4 ± 9.8 标准差年)。患者所从事的运动类型不同(足球、田径、体操、篮球)。最常涉及的解剖部位是下肢,诊断时间从 2 天到 4 年不等。最常用的治疗方法是药物和物理治疗,但有时也会采用侵入性方法,如区域神经或腰椎交感神经阻滞。主要评估的结果是恢复活动和疼痛。

我们的综述表明,1 型 CRPS 在年轻人和下肢中的发病率高于一般人群,但在女性中的发病率更高。然而,关于运动员 CRPS 的研究数量有限,涉及的患者数量也有限,因为关于这个主题的病例报告很少且异质。此外,旧研究的高患病率(过去 10 年只有 5 项可用研究)可能影响了评估工具和管理策略的选择。尽管存在这些局限性,但对于运动相关损伤后出现不成比例疼痛的运动员,应通过多维方法及时进行评估和治疗,以避免痛性营养不良的长期后果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0e5/8623027/a167a4c0ad94/medicina-57-01262-g001.jpg

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