Center for Interdisciplinary Pain Medicine, Department of Anesthesiology, University Hospital of Würzburg, Würzburg, Germany.
Department of Neurology, University Hospital of Mainz, Mainz, Germany.
Eur J Pain. 2022 Mar;26(3):719-728. doi: 10.1002/ejp.1900. Epub 2022 Jan 5.
Complex regional pain syndrome (CRPS) is an orphan disease occurring as a complication after trauma. Due to its acute onset and the typical clinical presentation of the inflammatory and autonomous signs, it is an eye-catching chronic pain disease affecting also young and working people. In social media and the internet, high pain severity and the unfavourable prognosis are often empathized.
Here, we compared epidemiological, pain and lifestyle factors of 223 CPRS patients from the "ncRNAPain" cohort with 255 patients with chronic musculoskeletal pain (MSK). MSK patients were recruited at the beginning of a multimodal pain therapy programme. We searched for factors predicting pain intensity.
Both chronic pain diseases affected women in middle age. Patients with MSK were more obese, drank more alcohol, and were less educated (Pearson chi-square Test or Mann-Whitney/U-Test). Both groups smoked more than healthy people in the OECD (Organization for Economic Cooperation and Development). Mann-Whitney/U-Test confirmed that CRPS patients did not have more severe pain and did not suffer more from pain-related disability than patients with MSK. CRPS patients also had less psychiatric comorbidities. Multiple linear regression analysis revealed that group assignment, depressive characteristics, body mass index, average alcohol consumption and smoking predicted higher pain ratings, while disease duration, anxiety symptoms or gender had no influence on pain intensity.
In summary, our study supports a more optimistic view on pain in CRPS patients in comparison to MSK and identifies lifestyle factors that might contribute to the pathophysiology like smoking and drinking. Important next steps are the identification of CRPS patients at risk for chronification or-vice versa-with protective factors for pain resolution.
This study compares complex regional pain syndrome (CRPS) and chronic musculoskeletal pain and questions previously reported pain, disability and lifestyle factors associated with CRPS.
复杂性区域疼痛综合征（CRPS）是一种创伤后并发症的孤儿病。由于其急性发作和炎症及自主征象的典型临床表现，它是一种引人注目的慢性疼痛疾病，也会影响年轻人和工作人群。在社交媒体和互联网上，人们经常强调其高疼痛严重程度和不利预后。
在这里，我们将“ncRNAPain”队列中的 223 例 CRPS 患者与 255 例慢性肌肉骨骼疼痛（MSK）患者的流行病学、疼痛和生活方式因素进行了比较。MSK 患者在多模式疼痛治疗计划开始时招募。我们寻找了预测疼痛强度的因素。
两种慢性疼痛疾病都影响中年女性。MSK 患者更肥胖，饮酒更多，受教育程度更低（皮尔逊卡方检验或曼-惠特尼 U 检验）。两组患者的吸烟量均高于经合组织（经济合作与发展组织）中的健康人群。曼-惠特尼 U 检验证实，CRPS 患者的疼痛程度并不比 MSK 患者更严重，也没有遭受更多与疼痛相关的残疾。CRPS 患者的精神共病也较少。多元线性回归分析显示，分组、抑郁特征、体重指数、平均酒精摄入量和吸烟量预测疼痛评分更高，而疾病持续时间、焦虑症状或性别对疼痛强度没有影响。
总的来说，与 MSK 相比，我们的研究支持对 CRPS 患者的疼痛持更乐观的看法，并确定了可能对病理生理学有贡献的生活方式因素，如吸烟和饮酒。重要的下一步是确定有慢性化风险的 CRPS 患者或具有疼痛缓解保护因素的患者。
本研究比较了复杂性区域疼痛综合征（CRPS）和慢性肌肉骨骼疼痛，并对以前报道的与 CRPS 相关的疼痛、残疾和生活方式因素提出了质疑。
