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Peripheral Neuropathic Pain and Pain Related to Complex Regional Pain Syndrome with and without Fixed Dystonia – Efficient Therapeutic Approach with Local Anesthetics

Authors Michels T

Received 30 August 2019

Accepted for publication 17 December 2019

Published 31 January 2020 Volume 2020:13 Pages 11—16

DOI https://doi.org/10.2147/LRA.S229315

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Stefan Wirz


Thomas Michels

Internal Medicine, Hematology, Radiology, Natural Cure, Cologne (Köln) 50968, Germany

Correspondence: Thomas Michels
Internal Medicine, Hematology, Radiology, Natural Cure, Pferdmengesstr.8, Cologne (Köln) 50968, Germany
Email dr.th.michels@web.de

Abstract: Peripheral Neuropathic Pain (PNP) as well as the Complex Regional Pain Syndrome (CRPS), also known as “Reflex Sympathetic Dystrophy”, or “Sudeck Dystrophy”, all of them have a poor prognosis. The numerous therapeutic offers are rarely accompanied by convincing success over a long duration of time. Even worse is the prognosis of a fixed dystonia which may develop in the extremities of PNP or CRPS patients. In literature a few cases are reported in which the often unbearable pain of those patients with or without a disabling dystonia disappeared immediately after the injection of local anesthetics (LAs) into the scars of a preceding trauma. This review evaluates publications concerning the neuropathological characteristics of fixed dystonia in PNP/CRPS patients and the electrophysiological processes of scar neuromas. The results of these evaluations support the understanding of the therapeutic successes and their immediate results reported above by the injection of LAs into triggering scars. Therapeutic options are discussed.

Keywords: peripheral neuropathic pain, complex regional pain syndrome, fixed dystonia, scar neuroma, local anesthetics, subthreshold membrane potential oscillations


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