Department of Anesthesiology and Pain Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Department of Palliative Care, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
J Palliat Med. 2023 Sep;26(9):1302-1306. doi: 10.1089/jpm.2022.0539. Epub 2023 Jul 21.
Complex regional pain syndrome is a chronic debilitating pain disorder that is difficult to manage, in part due to its heterogeneous clinical presentation and lack of clearly defined pathophysiology. Patients usually require a multidisciplinary approach to treatment, which can entail pharmacotherapy, physical therapy, behavioral therapy, and interventional pain procedures, such as sympathetic nerve blocks, spinal cord stimulation, and dorsal root ganglion stimulation. However, many patients continue to experience pain refractory to these multimodal strategies. Scrambler therapy (ST) is a noninvasive method of neuromodulation that is applied through cutaneous electrodes, and can alleviate chronic neuropathic pain by stimulating C-fibers and replacing endogenous pain signals with synthetic non-nociceptive signals. Although the use of ST has been reported for several types of refractory central and peripheral neuropathic pain, there is a paucity of data regarding the use of ST for complex regional pain syndrome. We present two patients with complex regional pain syndrome of the right lower extremity, who each underwent ST and experienced significant pain relief and improvement in function and quality of life.
复杂性区域疼痛综合征是一种慢性衰弱性疼痛障碍，难以治疗，部分原因是其临床表现异质性和缺乏明确界定的病理生理学。患者通常需要多学科治疗方法，包括药物治疗、物理治疗、行为治疗和介入性疼痛程序，如交感神经阻滞、脊髓刺激和背根神经节刺激。然而，许多患者仍然经历对这些多模式策略有抵抗力的疼痛。神经调控刺激仪疗法（ST）是一种通过皮肤电极进行的非侵入性神经调节方法，通过刺激 C 纤维并用合成的非伤害性信号代替内源性疼痛信号，可以缓解慢性神经性疼痛。尽管已经报道了 ST 用于几种类型的难治性中枢和周围神经性疼痛，但关于 ST 用于复杂性区域疼痛综合征的数据很少。我们介绍了两名患有右下肢复杂性区域疼痛综合征的患者，他们都接受了 ST 治疗，经历了显著的疼痛缓解以及功能和生活质量的改善。
