Clinical Course and Impact of Complex Regional Pain Syndrome Confined to the Knee

A Review of the Application of Myofascial Release Therapy in the Treatment of Diseases

Myofascial release (MFR) therapy is widely used in clinical practice to treat various musculoskeletal and pain-related conditions. However, there is a lack of comprehensive reviews that systematically evaluate its effectiveness across different medical conditions, leading to inconsistent applications and understanding of its therapeutic potential. This review aims to synthesize the current applications of myofascial release therapy in the treatment of various diseases, highlighting its efficacy and identifying areas where further research is needed. The review covers the application of myofascial release therapy in conditions such as chronic pain, fibromyalgia, post-surgical recovery, and neurological disorders. It evaluates the outcomes of existing studies, identifies gaps in the literature, and discusses the mechanisms through which myofascial release exerts its effects. Additionally, the review provides insights into the limitations of current research and suggests directions for future studies to enhance the clinical application of myofascial release therapy.

Psychiatric Comorbidity and Complex Regional Pain Syndrome Through the Lens of the Biopsychosocial Model: A Comparative Study

PURPOSE

To compare the prevalence of psychiatric comorbidity between patients with complex regional pain syndrome (CRPS) of the hand and non-CRPS patients and to assess the association between biopsychosocial (BPS) complexity profiles and psychiatric comorbidity in a comparative study.

PATIENTS AND METHODS

We included a total of 103 patients with CRPS of the hand and 290 patients with chronic hand impairments but without CRPS. Psychiatric comorbidities were diagnosed by a psychiatrist, and BPS complexity was measured by means of the INTERMED. The odds ratios (OR) of having psychiatric comorbidities according to BPS complexity were calculated with multiple logistic regression (adjusted for age, sex, and pain).

RESULTS

Prevalence of psychiatric comorbidity was 29% in CRPS patients, which was not significantly higher than in non-CRPS patients (21%, relative risk=1.38, 95% CI: 0.95 to 2.01 p=0.10). The median total scores of the INTERMED were the same in both groups (23 points). INTERMED total scores (0-60 points) were related to an increased risk of having psychiatric comorbidity in CRPS patients (OR=1.46; 95% CI: 1.23-1.73) and in non-CRPS patients (OR=1.21; 95% CI: 1.13-1.30). The four INTERMED subscales (biological, psychological, social, and health care) were correlated with a higher risk of having psychiatric comorbidity in both groups. The differences in the OR of having psychiatric comorbidity in relation to INTERMED total and subscale scores were not statistically different between the two groups.

CONCLUSION

The total scores, as well as all four dimensions of BPS complexity measured by the INTERMED, were associated with psychiatric comorbidity, with comparable magnitudes of association between the CRPS and non-CRPS groups. The INTERMED was useful in screening for psychological vulnerability in the two groups.

Complex regional pain syndrome as a result of total knee arthroplasty: A case report and review of literature

Total knee arthroplasty (TKA) is an effective treatment for patients with end-stage symptomatic knee osteoarthritis. As the aging population grows, the demand for the procedure is projected to increase. While highly successful, TKA has associated risks and complications. Complex regional pain syndrome is one uncommon but debilitating complication that can negatively impact patient satisfaction and quality of life. We present a case of complex regional pain syndrome in the operated leg that resulted in significant functional deficits. Key findings of this case include significant and disproportionate pain in the joint, altered cutaneous sensation around the joint, and decreased range of motion in flexion in the absence of any mechanical issues with the TKA. Because of the debilitating nature of this condition, patients must be fully informed of and realize the risks associated with undergoing a widely appreciated procedure such as TKA.