Complex regional pain syndrome type I after myocardial infarction treated with spinal cord stimulation.
OBJECTIVE
A rare case of Complex Regional Pain Syndrome (CRPS) type I after myocardial infarction (MI) and significant comorbid illness with few treatment options for pain control was successfully managed with the placement of a spinal cord stimulator (SCS).


METHODS
A 44-year-old man presented with left upper extremity burning pain after MI. His past medical history included insulin-dependent diabetes mellitus, oxygen-dependent idiopathic pulmonary fibrosis, and recent coronary revascularization surgery. His pain was presumed to be related to his MI and a clinical diagnosis of CRPS type I (or reflex sympathetic dystrophy) was made. Facing limited medical and less invasive options for his pain relief, he underwent a spinal cord stimulation trial with excellent response. He had more than 70% pain relief from the spinal cord stimulation at the last follow-up, 2 years later.


CONCLUSIONS
CRPS type I after MI can be difficult to treat because of other comorbid illnesses. SCS can be a safe and effective mode of therapy for patients facing limited treatment options.
Ahmed
Shihab U
SU
Massachusetts General Hospital Pain Center, Department of Anesthesia and Critical Care, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA. sahmed@partners.org
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D004599:Electric Stimulation Therapy; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications*; D011658:Pulmonary Fibrosis / Q000150:complications; D012019:Reflex Sympathetic Dystrophy / Q000209:etiology* / Q000628:therapy*; D013116:Spinal Cord / Q000502:physiology*