Melin M Mark, Rasmussen John C, Aldrich Melissa B, Karni Ron J, Fife Caroline E, Eckert Kristen A
Gonda Vascular Center, Wound Clinic, Mayo Clinic, Rochester, MN, United States.
Brown Foundation Institute of Molecular Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States.
Front Pain Res (Lausanne). 2025 Jun 26;6:1540930. doi: 10.3389/fpain.2025.1540930. eCollection 2025.
A previous report of 4 heterogeneous cases demonstrated that automated manual lymphatic drainage therapy (AMLDT), administered by a novel, pneumatic mat of 16 pressurized air channels that inflate and deflate sequentially to mimic the stretch and release action of manual lymphatic drainage therapy (MLD), altered lymphatic contractility and relieved pain. Near-infrared fluorescence imaging (NIRF-LI) was used 1 h before AMLDT, during 1 h of AMDLT, and 30-60 min after treatment to obtain images that could be used to determine lymphatic contractility, as measured by pulsing frequency over a given timeframe. Herein, a case of type 2 complex regional pain syndrome (CRPS, with nerve dysfunction confirmed) and lymphedema following a complex fracture on the lower leg is reported in further detail, with a discussion explaining the association between autonomic and lymphatic dysfunction and their combined contribution to the development of chronic pain. More specifically, this case provides clinical evidence of the association between autonomic nervous system dysfunction, lymphatic dysfunction, and CRPS. We believe that the regulation of lymphatic flow is a potential therapeutic pathway to alleviate the symptoms of CRPS. Further research on the association between autonomic and lymphatic dysfunction and pain is warranted, particularly in patients with CRPS and symptoms of edema following leg fractures.
之前一份关于4例不同病例的报告表明，由一种新型的、带有16个加压空气通道的气动垫进行的自动手动淋巴引流疗法（AMLDT），该气动垫通过依次充气和放气来模拟手动淋巴引流疗法（MLD）的拉伸和释放动作，可改变淋巴收缩力并缓解疼痛。在AMLDT治疗前1小时、AMLDT治疗1小时期间以及治疗后30 - 60分钟使用近红外荧光成像（NIRF - LI）来获取图像，这些图像可用于确定淋巴收缩力，通过给定时间范围内的脉冲频率来衡量。在此，进一步详细报告一例2型复杂性区域疼痛综合征（CRPS，神经功能障碍已得到证实）及小腿复杂骨折后发生淋巴水肿的病例，并讨论自主神经功能障碍与淋巴功能障碍之间的关联以及它们对慢性疼痛发展的共同作用。更具体地说，该病例提供了自主神经系统功能障碍、淋巴功能障碍与CRPS之间关联的临床证据。我们认为，调节淋巴流动是缓解CRPS症状的一条潜在治疗途径。有必要进一步研究自主神经功能障碍与淋巴功能障碍及疼痛之间的关联，特别是在患有CRPS且小腿骨折后出现水肿症状的患者中。
