Pain practice : the official journal of World Institute of Pain
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The aim of the study was to define risk factors related to pain in adult end-stage renal disease (ESRD) patients on chronic intermittent hemodialysis (HD) by developing a systematic review of published data. ⋯ Multiple factors for various types of pain in very heterogeneous populations and heterogeneous settings were analyzed in the literature. The results turned out to be inconsistent between the studies. Future large-scale studies are required, taking into the account limitations of the current evidence base.
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Complex regional pain syndrome (CRPS) occurs due to different pathophysiological mechanisms. Presently there is no description of definitive treatment that can resolve the especially recalcitrant motor issues of disability in CRPS type 1 (CRPS-1). ⋯ In this patient with CRPS-1, intra-articular injections with steroid reduced nociception in the affected local structures and sensitization in the nervous system; dry needling resolved the myofascial issues; sustained physiotherapy maintained the motor recovery; and behavioral therapy techniques addressed the cognitive and life stress issues. It was concluded that the presenting symptoms in this case were a consequence of interactions between humoral, nervous, and myofascial systems.