Aldera Mai, Alkhaldi Hatem Askar, Felemban Mutaz, Alaraik Ayman
Department of Rehabilitation Science, King Saud University College of Applied Medical Sciences, Riyadh, Saudi Arabia
Department of Rehabilitation Medicine, King Saud University College of Medicine, Riyadh, Saudi Arabia.
BMJ Case Rep. 2025 Apr 29;18(4):e263910. doi: 10.1136/bcr-2024-263910.
Orofacial complex regional pain syndrome (O-CRPS) presents a diagnostic challenge due to its overlap with other orofacial pain conditions. This case report highlights the value of a multidisciplinary approach in managing a patient with chronic and unexplained facial pain.This case report aims to illustrate: (1) the application of a multidisciplinary approach in diagnosing and managing O-CRPS within the Saudi healthcare system, and (2) the effectiveness of the Self-Training Educative Pain Sensation (STEPS) model in managing O-CRPS.
A woman in her early 20s presented with left-sided facial pain and motor/autonomic symptoms following a facial injury. Extensive evaluations by various specialists excluded underlying structural pathology. A diagnosis of O-CRPS was established based on Budapest criteria. The STEPS model was implemented for treatment.
The STEPS model, a four-component intervention (pain education, graded motor imagery, sensory exposure, facial muscle exercises), aimed to reduce allodynia, normalise motor control and restore important functional activities.
Initial pain medications were ineffective. The STEPS model intervention significantly improved pain, function and overall quality of life.This case report emphasises the importance of a multidisciplinary approach to diagnosing O-CRPS and the potential benefits of the STEPS model in managing this complex condition.
口面部复杂性区域疼痛综合征（O-CRPS）因其与其他口面部疼痛病症存在重叠而带来诊断挑战。本病例报告强调了多学科方法在管理一名患有慢性且不明原因面部疼痛患者中的价值。本病例报告旨在说明：（1）多学科方法在沙特医疗系统中诊断和管理O-CRPS的应用，以及（2）自我训练性疼痛感觉（STEPS）模型在管理O-CRPS方面的有效性。
一名20岁出头的女性在面部受伤后出现左侧面部疼痛以及运动/自主神经症状。多位专家进行的广泛评估排除了潜在的结构病理学问题。根据布达佩斯标准确诊为O-CRPS。采用STEPS模型进行治疗。
STEPS模型是一种包含四个组成部分的干预措施（疼痛教育、分级运动想象、感觉暴露、面部肌肉锻炼），旨在减轻异常性疼痛、使运动控制正常化并恢复重要的功能活动。
最初的止痛药物无效。STEPS模型干预显著改善了疼痛、功能和整体生活质量。本病例报告强调了多学科方法在诊断O-CRPS中的重要性以及STEPS模型在管理这种复杂病症方面的潜在益处。
