Role of biphosphonates and lymphatic drainage type Leduc in the complex regional pain syndrome (shoulder-hand syndrome).

BACKGROUND: Complex regional pain syndrome (CRPS) is a clinical entity that has been termed in numerous ways in the last years. Clinically, CRPS describes an array of painful conditions that are characterized by a continuing (spontaneous and/or evoked) regional pain that is seemingly disproportionate in time or degree to the usual course of any known trauma or other lesion. The pain is regional and usually has a distal predominance of abnormal sensory, motor, sudomotor, vasomotor, and/or trophic findings.

DESIGN: Case report.

SETTING: University Medical Center. Patients. In this report, we described the case of a 68-year-old hemiplegic female affected by cerebrovascular accident that presented a clinical case of CRPS shoulder-hand syndrome (CRPS-SHS) at the right hand after a hemorrhagic stroke.

INTERVENTIONS: This report evaluated the effects of biphosphonates and lymphatic drainage type Leduc in CRPS-SHS.

OUTCOME MEASURES: The pain level of the patients was measured with the visual analog scale. A scoring system for the clinical severity of CRPS-SHS, laboratory tests, and X-ray films were also performed.

RESULTS: We reported in this patient a great improvement of pain and edema of the right hand, with a significant reduction of bone demineralization.

CONCLUSIONS: This combined treatment may be a viable alternative for this syndrome; however, further investigation is needed to determine its reproducibility in large case series.