SpringerLink
Log in

Komplementäre Verfahren in der Behandlung des komplexen regionalen Schmerzsyndroms

Complementary methods in the treatment of complex regional pain syndrome

  • Schwerpunkt
  • Published:
Der Schmerz Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Das komplexe regionale Schmerzsyndrom („complex regional pain syndrome“ [CRPS]) betrifft 10–15 % der PatientInnen nach Verletzungen (Frakturen, Operationen) der äußeren Extremitäten und Menschen nach Schlaganfall. Die betroffene Stelle schmerzt, zeigt entzündliche Symptome, ist kraftlos, Beweglichkeit und Sensibilität sind eingeschränkt. Die Komplementärmedizin als Bestandteil der integrativen Medizin bietet zusätzliche wirkungsvolle Behandlungsoptionen.

Fragestellung

Es werden komplementäre Therapien vorgestellt, die die Leitlinienempfehlungen erweitern, klinische Evidenz aufweisen und/oder plausibel sind.

Ergebnisse

Verfahren der Mind-body-Medizin wie Achtsamkeit, Entspannung, Yoga oder Qigong unterstützen die Selbstwirksamkeit der PatientInnen, regen den Vagusnerv an und fördern den Abbau von Schmerzen, Depression und Angst. Zudem verbessern sie die Lebensqualität. Phytotherapeutika, wie Kurkuma oder Brennnessel, wirken antiinflammatorisch. Behandlungen mit Wasser reduzieren die Schmerzen. Akupunktur und Neuraltherapie können versucht werden.

Schlussfolgerungen

Integrativ-komplementärmedizinische Therapieoptionen unterstützen die CRPS-PatientInnen bei der Bewältigung der Krankheit und der Schmerzen. Sie können eine wichtige Rolle in der multimodalen, interdisziplinären Behandlung des CRPS spielen.

Abstract

Background

Complex regional pain syndrome (CRPS) affects 10–15% of patients following injuries (fractures, surgery) to the outer extremities and people after a stroke. The affected area hurts, is inflamed and lacks strength, while mobility and sensitivity are restricted. Complementary medicine as part of integrative medicine offers additional effective treatment options.

Research question

Complementary therapies that extend the guideline recommendations, demonstrate clinical evidence and/or are plausible are presented.

Results

Mind-body medicine procedures (mindfulness, relaxation, yoga, Qi Gong, etc.) support the patient’s self-efficacy and stimulate the vagus nerve as well as promoting the reduction of pain, depression and anxiety and improving quality of life. Phytotherapeutics such as turmeric or stinging nettle have an anti-inflammatory effect. Water treatments reduce pain, and acupuncture and neural therapy can be tried.

Conclusions

Integrative, complementary medical therapy options support the CRPS patient in co** with their disease and the related pain. These options can play an important role in the multimodal, interdisciplinary treatment of this disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price includes VAT (United Kingdom)

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. van Velzen GAJ, Perez R, van Gestel MA et al (2014) Health-related quality of life in 975 patients with complex regional pain syndrome type 1. Pain 155(3):629–634

    Article  PubMed  Google Scholar 

  2. Sudeck P (1900) Über die acute entzündliche Knochenatrophie. Arch Klin Chir 62:147–156

    Google Scholar 

  3. Ott S, Maihofner C (2018) Signs and symptoms in 1,043 patients with complex regional pain syndrome. J Pain 19(6):599–611

    Article  PubMed  Google Scholar 

  4. de Mos M, de Bruijn AG, Huygen FJ et al (2007) The incidence of complex regional pain syndrome: a population-based study. Pain 129(1–2):12–20

    Article  PubMed  Google Scholar 

  5. Johnson S, Cowell F, Gillespie S et al (2022) Complex regional pain syndrome what is the outcome?—a systematic review of the course and impact of CRPS at 12 months from symptom onset and beyond. Eur J Pain 26(6):1203–1220

    Article  PubMed  PubMed Central  Google Scholar 

  6. Deutsche Gesellschaft für Neurologie. Diagnostik und Therapie komplexer regionaler Schmerzsyndrome (CRPS). https://register.awmf.org/assets/guidelines/030-116l_S1_Schmerzsyndrome_CRPS_2018-09.pdf. Zugegriffen: 4. Jan. 2023

  7. O’Connell NE, Wand BM, McAuley J et al (2013) Interventions for treating pain and disability in adults with complex regional pain syndrome. Cochrane Database Syst Rev 2013(4):CD9416

    PubMed  PubMed Central  Google Scholar 

  8. Smart KM, Ferraro MC, Wand BM et al (2022) Physiotherapy for pain and disability in adults with complex regional pain syndrome (CRPS) types I and II. Cochrane Database Syst Rev 5(5):CD10853

    PubMed  Google Scholar 

  9. Kessler A, Yoo M, Calisoff R (2020) Complex regional pain syndrome: An updated comprehensive review. NeuroRehabilitation 47(3):253–264

    Article  PubMed  Google Scholar 

  10. McCormick ZL, Gagnon CM, Caldwell M et al (2015) Short-term functional, emotional, and pain outcomes of patients with complex regional pain syndrome treated in a comprehensive interdisciplinary pain management program. Pain Med 16(12):2357–2367

    Article  PubMed  Google Scholar 

  11. Dusek JA, Gao Q, Kim RS et al (2022) Patients receiving integrative medicine effectiveness registry (PRIMIER) of the bravenet practice-based research network: outcomes of the PRIMIER cohort. Complement Ther Med 71:102904

    Article  PubMed  Google Scholar 

  12. Saha FJ, Bruning A, Barcelona C et al (2016) Integrative medicine for chronic pain: A cohort study using a process-outcome design in the context of a department for internal and integrative medicine. Med (Baltim) 95(27):e4152

    Article  Google Scholar 

  13. Harden RN, McCabe CS, Goebel A et al (2022) Complex regional pain syndrome: practical diagnostic and treatment guidelines, 5th edition. Pain Med 23(Suppl 1):S1–S53

    Article  PubMed  PubMed Central  Google Scholar 

  14. Park HY, Jang YE, Oh S et al (2020) Psychological characteristics in patients with chronic complex regional pain syndrome: comparisons with patients with major depressive disorder and other types of chronic pain. J Pain Res 13:389–398

    Article  PubMed  PubMed Central  Google Scholar 

  15. Baronio M, Sadia H, Paolacci S et al (2020) Molecular aspects of regional pain syndrome. Pain Res Manag 2020:7697214

    Article  PubMed  PubMed Central  Google Scholar 

  16. Gerritsen RJS, Band GPH (2018) Breath of life: the respiratory vagal stimulation model of contemplative activity. Front Hum Neurosci 12:397

    Article  PubMed  PubMed Central  Google Scholar 

  17. Schlechta Portella CF, Ghelman R, Abdala V et al (2021) Meditation: evidence map of systematic reviews. Front Public Health 9:742715

    Article  PubMed  PubMed Central  Google Scholar 

  18. Wu WH, Bandilla E, Ciccone DS et al (1999) Effects of qigong on late-stage complex regional pain syndrome. Altern Ther Health Med 5(1):45–54

    CAS  PubMed  Google Scholar 

  19. Streeter CC, Gerbarg PL, Saper RB et al (2012) Effects of yoga on the autonomic nervous system, gamma-aminobutyric-acid, and allostasis in epilepsy, depression, and post-traumatic stress disorder. Med Hypotheses 78(5):571–579

    Article  CAS  PubMed  Google Scholar 

  20. Dusek JA, Otu HH, Wohlhueter AL et al (2008) Genomic counter-stress changes induced by the relaxation response. Plos One 3(7):e2576

    Article  PubMed  PubMed Central  Google Scholar 

  21. Keles YB, Onder B, Kesiktas FN et al (2020) Acute effects of contrast bath on sympathetic skin response in patients with poststroke complex regional pain syndrome. Somatosens Mot Res 37(4):320–325

    Article  Google Scholar 

  22. Devrimsel G, Turkyilmaz AK, Yildirim M et al (2015) The effects of whirlpool bath and neuromuscular electrical stimulation on complex regional pain syndrome. J Phys Ther Sci 27(1):27–30

    Article  PubMed  PubMed Central  Google Scholar 

  23. Peng Y, Ao M, Dong B et al (2021) Anti-inflammatory effects of curcumin in the inflammatory diseases: status, limitations and countermeasures. Drug Des Devel Ther 15:4503–4525

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Hsiao AF, Lien YC, Tzeng IS et al (2021) The efficacy of high- and low-dose curcumin in knee osteoarthritis: A systematic review and meta-analysis. Complement Ther Med 63:102775

    Article  PubMed  Google Scholar 

  25. European Medicines Agency https://www.ema.europa.eu/en/documents/herbal-report/final-assessment-report-curcuma-longa-l-rhizoma-revision-1_en.pdf. Zugegriffen: 3. Jan. 2023

  26. Siddiqui MZ (2011) Boswellia serrata, a potential antiinflammatory agent: an overview. Indian J Pharm Sci 73(3):255–261

    CAS  PubMed  PubMed Central  Google Scholar 

  27. Memoarial Sloan Kettering Cancer Center About herbs. https://www.mskcc.org/cancer-care/diagnosis-treatment/symptom-management/integrative-medicine/herbs. Zugegriffen: 3. Jan. 2023

  28. Devkota HP, Paudel KR, Khanal S et al (2022) Stinging nettle (Urtica dioica L.): nutritional composition, bioactive compounds, and food functional properties. Molecules 27(16):5219

  29. European Medicines Agency https://www.ema.europa.eu/en/documents/herbal-report/final-assessment-report-urtica-dioica-l-urtica-urens-l-folium_en.pdf. Zugegriffen: 4. Jan. 2023

  30. Petzke F, Tolle T, Fitzcharles MA et al (2022) Cannabis-based medicines and medical cannabis for chronic neuropathic pain. CNS Drugs 36(1):31–44

    Article  CAS  PubMed  Google Scholar 

  31. Burstein S (2015) Cannabidiol (CBD) and its analogs: a review of their effects on inflammation. Bioorg Med Chem 23(7):1377–1385

    Article  CAS  PubMed  Google Scholar 

  32. Seth I, Bulloch G, Seth N et al (2022) Effect of perioperative vitamin C on the incidence of complex regional pain syndrome: a systematic review and meta-analysis. J Foot Ankle Surg 61(4):748–754

    Article  PubMed  Google Scholar 

  33. Liu S, Zhang CS, Cai Y et al (2019) Acupuncture for post-stroke shoulder-hand syndrome: a systematic review and meta-analysis. Front Neurol 10:433

    Article  PubMed  PubMed Central  Google Scholar 

  34. Storz C, Kraft E (2020) CRPS: Aktuelle Erkenntnisse und Empfehlungen aus der Forschung. manuelletherapie 24(5):223–226

    Article  Google Scholar 

  35. Girtler R, Kloimstein H, Gustorff B (2013) Pronounced symptom deterioration in complex regional pain syndrome type II after isolated application of a highly concentrated capsaicin patch. A case report. Schmerz 27(1):67–71

    Article  CAS  PubMed  Google Scholar 

  36. Fischer L, Pfister M (2007) Wirksamkeit der Neuraltherapie bei überwiesenen Patienten mit therapieresistenten chronischen Schmerzen. Schweiz Z Ganzheitsmed 19(1):30–35

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik für Naturheilkunde & Integrative Medizin, KEM | Evang. Kliniken Essen-Mitte, Am Deimelsberg 34a, 45276, Essen, Deutschland

    T. Gabriel & P. Klose

Authors
  1. T. Gabriel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. Klose
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to T. Gabriel.

Ethics declarations

Interessenkonflikt

T. Gabriel und P. Klose geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Additional information

figure qr

QR-Code scannen & Beitrag online lesen

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gabriel, T., Klose, P. Komplementäre Verfahren in der Behandlung des komplexen regionalen Schmerzsyndroms. Schmerz 37, 330–335 (2023). https://doi.org/10.1007/s00482-023-00724-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00482-023-00724-7

Schlüsselwörter

Keywords

Search

Navigation