Effectiveness of Hyperbaric Oxygen Therapy in the Treatment of Complex Regional Pain Syndrome Department of Physical Therapy and Rehabilitation and Department of Underwater and Hyperbaric Medicine Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey.
In this double-blind, randomized, placebo-controlled study we aimed to assess the effectiveness of hyperbaric oxygen (HBO) therapy for treating patients with complex regional pain syndrome (CRPS). Of the 71 patients, 37 were allocated to the HBO group and 34 to the control (normal air) group. Both groups received 15 therapy sessions in a hyperbaric chamber. Pain, edema and range of motion (ROM) of the wrist were evaluated before treatment, after the 15th treatment session and on day 45. In the HBO group there was a sign significant decrease in pain and edema and a significant increase in the ROM of the wrist. When we compared the two groups, the HBO group had significantly better results with the exception of wrist extension. In conclusion, HBO is an effective and well-tolerated method for decreasing pain and edema and increasing the ROM in patients with CRPS. Introduction.
Severe local pains in the extremities, skin color changes, hypo- or hyperhydrosis and localized osteoporosis characterize complex regional pain syndrome (CRPS). Since its original description by Mitchell in 1864, CRPS, previously known as reflex sympathetic dystrophy, has been a poorly understood and frequently overlooked condition! And its etiology remains unclear. Trauma, which is often mild, is the main etiological factor but not the only one.2 Moreover, there is no relationship between the severity of trauma and the severity of the syndrome.3 the pathogenetic universally accepted mechanism proposed by Leriche is sympathetic-reflex imbalance.4 a factor contributing to many chronic pain syndromes is over activity of the sympathetic nervous system. The patient’s pain is usually diffuse and does not correspond to a dermatome or peripheral nerve distribution. The clinical symptoms of CRPS arise from the sensory, motor and sympathetic nervous systems. Early diagnosis influences the response to treatment and the evolution of the disease. There are three stages in the development of CRPS: acute (stage I), dystrophic (stage II) and atrophic (stage II!).