[Inpatient treatment for CRPS I by use of complementary medicine].
BACKGROUND
Complex regional pain syndromes (CRPS) are mainly characterized by a burning, intense spontaneous pain,mechanical allodynia of the affected limb, disorders of the skin,local hyperhidrosis, lymphedema as well as trophic disorders of the skin, bones and joints. The overall clinical appearance is dominated by a dysfunction of the sympathetic nervous system. One dominant etiological hypothesis is that major mechanisms for CRPS symptoms, which might be present during the course of CRPS, are trauma-related cytokine release, exaggerated neurogenic inflammation, sympathetically maintained pain, and cortical reorganization in response to chronic pain.


METHODS
We report the case of a 33-year-old female patient who suffered from a CRPS type I (cold type) of the left foot which had been traumatically induced 9 months before. The patient presented with a severe pain syndrome, an allodynia of the dermatomes L5 and S1 left with significant trophic skin disturbances, followed by a lymphedema and a malposition (pronation) of the left dorsum pedis.


METHODS
In the course of a 10-week in-house treatment the patient received a multidisciplinary therapy-management based on complementary medicine with intensive use of hydrotherapy according to Kneipp, and physiotherapy.


RESULTS
Pain intensity over treatment decreased from 8 (initial) to 2 (after 8 weeks) ona 10-point numeric rating scale. Furthermore, local symptoms of the left foot, i.e. hyperhidrosis, trophic skin disorders and lymphedema decreased significantly.


CONCLUSIONS
Therapeutic strategies derived from complementary medicine may be an effective approach to the complex treatment of CRPS. Their effects should be further investigated in controlled clinical trials.
Kneipp'sche Kliniken, Kneippstrasse 8, Bad Wörishofen, Germany. dr.schencking@barmherzige-bad-woerishofen.de
Martin
M
Schencking
Joachim
J
Bohmhammel
Claus
C
Keller
D000328:Adult; D001452:Balneology; D003131:Combined Modality Therapy; D000529:Complementary Therapies; D005260:Female; D018409:Foot Injuries / Q000150:complications; D006801:Humans; D006875:Hydrotherapy; D010147:Pain Measurement; D010343:Patient Admission; D010348:Patient Care Team; D026741:Physical Therapy Modalities; D012008:Recurrence; D012019:Reflex Sympathetic Dystrophy / Q000628:therapy*; D016896:Treatment Outcome