Revista de Medicina Desportiva (English) September 2018 | Page 11
would make the diagnosis of CRPS
type II.
This a long-lasting disease
which makes the multidisciplinary
approach the cornerstone for the
correct approach and planning. 11
The complexity and the rarity of this
pathology on a high-level athlete
created a deep and constant discus-
sion in order to take advantage of
several medical specialties for plan-
ning the treatment of this athlete.
Although there aren’t consen-
sus protocols for the treatment 12-14 ,
and in order to promote a fast and
complete rehabilitation, the athlete
followed a complete and long-lasting
recovery functional program as
whole, since he was without sports
competition for some months, allied
to percutaneous electrostimulation,
physiotherapy and pharmacological
agents. The good functional recovery
avoided sympathectomy blockages,
cognitive behavior therapy, neuro-
modulation and stimulation of neu-
roplasticity, which are usually used
for the chronic and refractories cases.
On high competition athletes,
where the time out of competition is
very important, it is fundamental to
explain the pathology and to involve
the athlete to follow a long treat-
ment plan to have healing without
sequelae of CRPS. Between 30 and
50% of patients with CRPS, especially
those with late diagnosis and treat-
ment, have clinical recurrence and/
or irreversible functional sequelae:
chronic pain and edema, ulceration,
skin infection, dystonia and myo-
clonus.
In this case report, of particular
interest for the clinical rarity that
it represents, the recommended
treatment allowed the athlete the
return to sports at a pre-injury level,
without relapse and sequelae of the
CRPS, which are quite often found
associated with this pathology.
The authors declare no conflicts of inte-
rest or economic.
Correspondence to:
[email protected]
Bibliography
1. Goebel A et al: Complex regional pain syn-
drome in adults: UK guidelines for diagnosis
and manegement in a prymary and secondary
care. London: RCP, 2012.
2. Harden, RN et al: S. Complex regional pain
syndrome: Practical diagnostic and treatment
guidelines, 4 th edition. Pain Medicine, 2013;
14(2):180-229.
3. Harden RN et al: Proposed new diagnostic
criteria for complex regional pain syndrome.
Pain Med, 2007; 8(4):326-31.
4. Pons T et al: Potencial risk factors for the onset
pf complex regional pain syndrome tipe I: a
systematic literature review. Anaesthesiology
Reserche and Practice, 2015; 2015:95639.
5. Brukhner & Khan´s Clinica Sports Medicine,
2012; 4 th Edition. Austrália. Mc Graw Hill.
6. Santos DM et al: Síndrome dolorosa regional
complexa tipo I num atleta de boxe. Rev Medi-
cina Desportiva informa, 2015; 6(5):6-8.
7. Gaer B et al: Complex regional pain syndro-
mes – type I: reflex sympathetic dystrophy and
type II: causalgia. Bonica´s Management of
Pain, 3 rd ed Lippincott Williams & Wilkins
2001; 389-408.
8. Martinez EM et al: Síndrome de dolor regional
complejo. Semin Fund Esp Reumatol, 2012;
13(1)31-36.
9. Allen G et al: epidemiological review of 134
patients with complex regional pain syndrome
assessed in a chronic pain clinic. Eur J Pain,
1999; 80:539-544.
10. Shurmann M et al: Imaging in early post-
traumatic complex regional pain syndrome: a
comparision of diagnostic methods. Clin J Pain,
2007; 23(5):449-457.
11. Harden RN et al: Interdisciplinary Manage-
ment. In: Harden RN, ed. Complex Regional Pain
Syndrome: Treatment Guidelines. Milford, CT:
RSDSA Press; 2006:12–24.
12. Trand D et all: Treatment of complex regional
pain syndrome: a review of the evidence. Can J
Anesth, 2010; 57:149-66.
13. White A et al: Medical Acupuncture: A Wes-
tern Scientific Approach, 2016; 2 nd . Elsevier.
14. Rowbotham MC: Pharmacologic management
of complex regional pain syndrome, Clin J Pain,
2006; 22(5):425-9.
15. Van Der Laan L et al: Sever complications of
reflex sympathetic dystrophy: infection, ulcers,
chronic dema, dystonia and myoclonus. Arch
Phys Med Rehabil 1998; 79:424-9.
15.º Curso de Pós-Graduação
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