Complex regional pain syndrome: a focus on the autonomic nervous system

Complex regional pain syndrome: a focus on the autonomic nervous system Purpose Although autonomic features are part of the diagnostic criteria for complex regional pain syndrome (CRPS), the role of the autonomic nervous system in CRPS pathophysiology has been downplayed in recent years. The purpose of this review is to redress this imbalance. Methods We focus in this review on the contribution of the autonomic nervous system to CRPS pathophysiology. In par- ticular, we discuss regional sympathetic and systemic autonomic disturbances in CRPS and the mechanisms which may underlie them, and consider links between these mechanisms, immune disturbances and pain. Results The focused literature research revealed that immune reactions, alterations in receptor populations (e.g., upregulation of adrenoceptors and reduced cutaneous nerve fiber density) and central changes in autonomic drive seem to contribute to regional and systemic disturbances in sympathetic activity and to sympathetically maintained pain in CRPS. Conclusions We conclude that alterations in the sympathetic nervous system contribute to CRPS pathology. Understanding these alterations may be an important step towards providing appropriate treatments for CRPS. Keywords Complex regional pain syndrome · Sympathetic nervous system · Central disturbances in autonomic activity · Immune system Complex regional pain syndrome: contusion or sprain combined with immobilization (CRPS an introduction type I) [13]. It is characterized by changes http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Clinical Autonomic Research Springer Journals

Complex regional pain syndrome: a focus on the autonomic nervous system

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Publisher
Springer Journals
Copyright
Copyright © 2019 by Springer-Verlag GmbH Germany, part of Springer Nature
ISSN
0959-9851
eISSN
1619-1560
D.O.I.
10.1007/s10286-019-00612-0
Publisher site
See Article on Publisher Site

Abstract

Purpose Although autonomic features are part of the diagnostic criteria for complex regional pain syndrome (CRPS), the role of the autonomic nervous system in CRPS pathophysiology has been downplayed in recent years. The purpose of this review is to redress this imbalance. Methods We focus in this review on the contribution of the autonomic nervous system to CRPS pathophysiology. In par- ticular, we discuss regional sympathetic and systemic autonomic disturbances in CRPS and the mechanisms which may underlie them, and consider links between these mechanisms, immune disturbances and pain. Results The focused literature research revealed that immune reactions, alterations in receptor populations (e.g., upregulation of adrenoceptors and reduced cutaneous nerve fiber density) and central changes in autonomic drive seem to contribute to regional and systemic disturbances in sympathetic activity and to sympathetically maintained pain in CRPS. Conclusions We conclude that alterations in the sympathetic nervous system contribute to CRPS pathology. Understanding these alterations may be an important step towards providing appropriate treatments for CRPS. Keywords Complex regional pain syndrome · Sympathetic nervous system · Central disturbances in autonomic activity · Immune system Complex regional pain syndrome: contusion or sprain combined with immobilization (CRPS an introduction type I) [13]. It is characterized by changes

Journal

Clinical Autonomic ResearchSpringer Journals

Published: May 18, 2019

References

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