Cha Joon, Bosco Gerardo, Moon Richard E, Melloni Giorgio, Camporesi Enrico M
Morsani College of Medicine.
Department of Biomedical Sciences, University of Padua, Padua, Italy.
Clin J Pain. 2025 Apr 1;41(4):e1276. doi: 10.1097/AJP.0000000000001276.
Complex regional pain syndrome remains a challenging condition characterized by severe, persistent pain and a variety of inflammatory and trophic symptoms. This study aimed to analyze the current literature to evaluate hyperbaric oxygen therapy (HBOT)'s efficacy in treating complex regional pain syndrome (CRPS), focusing on both sympathetically maintained pain (SMP) and sympathetically independent pain (SIP) subtypes.
A comprehensive literature search was conducted in PubMed Clinical Queries using the MeSH term "Complex Regional Pain Syndromes" OR the keyword "CRPS" AND "Hyperbaric Oxygen Therapy" OR the keyword "HBOT." The selected publication types included a randomized controlled trial, a retrospective observational study, a comparative study, a retrospective case series, and case reports. The search was restricted to articles published in English between January 1994 and October 2024. The results from the search were used to compile this review. Patients were categorized into SMP, SIP, or indeterminate groups based on the presence of prior sympathetic nerve block history or disease duration.
Thirteen studies involving 280 participants were reviewed. Of the patients, 42.5% were categorized as SMP, 48.2% as SIP, and 9.3% as indeterminate. HBOT treatment ranged from 3 to 63 sessions, typically using 2.4 atmospheres absolute for 90 minutes. The results indicated significant symptom relief and functional improvement across both SMP and SIP subtypes, suggesting the broad efficacy of HBOT for CRPS management.
This review of the current literature suggests that HBOT may offer significant symptom relief, regardless of CRPS subtype or disease duration. HBOT's anti-inflammatory and neuroplasticity promoting properties make it a valuable noninvasive option for CRPS patients, potentially improving outcomes when combined with other therapeutic modalities. Further research is necessary to refine patient selection and optimize treatment protocols.
复杂性区域疼痛综合征仍然是一种具有挑战性的病症，其特征为严重、持续的疼痛以及多种炎症和营养症状。本研究旨在分析当前文献，以评估高压氧疗法（HBOT）在治疗复杂性区域疼痛综合征（CRPS）方面的疗效，重点关注交感神经维持性疼痛（SMP）和交感神经独立性疼痛（SIP）亚型。
在PubMed临床查询中使用医学主题词“复杂性区域疼痛综合征”或关键词“CRPS”以及“高压氧疗法”或关键词“HBOT”进行全面的文献检索。所选的出版物类型包括随机对照试验、回顾性观察研究、比较研究、回顾性病例系列和病例报告。检索限于1994年1月至2024年10月期间以英文发表的文章。检索结果用于编写本综述。根据先前交感神经阻滞病史或病程，将患者分为SMP、SIP或不确定组。
对13项涉及280名参与者的研究进行了综述。在这些患者中，42.5%被归类为SMP，48.2%为SIP，9.3%为不确定。HBOT治疗疗程为3至63次，通常使用2.4绝对大气压，持续90分钟。结果表明，SMP和SIP亚型均有显著的症状缓解和功能改善，提示HBOT对CRPS管理具有广泛的疗效。
对当前文献的这一综述表明，无论CRPS亚型或病程如何，HBOT都可能带来显著的症状缓解。HBOT的抗炎和促进神经可塑性的特性使其成为CRPS患者有价值的非侵入性选择，与其他治疗方式联合使用时可能改善治疗结果。有必要进一步研究以优化患者选择并完善治疗方案。
