Complex Regional Pain Syndrome Reflex Sympathetic Dystrophy Syndrome Diagnosis and Therapy- a Review of 824 Patients (abstract Summary***)

Opioids play a major role in management of pain and inflammation in peripheral and central nervous system. The endogenous ligands-opioid peptides (endorphins) are expressed by resident immune cells in peripheral tissues. Depriving the patient of proper pain medication can aggravate the immune system dysfunction. The selection of proper opiates for treatment of CRPS is quite critical. Both opioid agonists and mixed opioid agonist-antagonists have been used for treatment of pain in such patients. Opiates are considered effective in treatment of neuropathic pain. However, due to the complexity and multiple origins of the pain in CRPS, in some patients the opioid agonists are not as effective. Morphine does not consistently reduce the neuropathic pain.