Subcutaneous platelet rich plasma therapy for management of hyperalgesia in complex regional pain syndrome

Abstract

Objectives: Complex regional pain syndrome (CRPS), which usually develops after a traumatic event, often has a debilitating effect on the quality of life. Treatment is multidisciplinary and is based primarily on pain relief. Due to the symptoms of hyperalgesia and allodynia in patients with CRPS, dermatology opinion is often seeked. CRPS is a difficult disorder to treat and platelet-rich plasma (PRP) is a potential treatment modality for pain relief in this debilitating illness. We aimed to investigate the role of subcutaneous PRP for relief of hyperalgesia in patients with CRPS. Materials and Methods: A comparative prospective study of 15 male patients with CRPS diagnosed clinically by the Budapest criteria and radiologically by magnetic resonance imaging was enrolled for the study. PRP was injected subcutaneously at biweekly interval for 8 weeks and the results were assessed clinically by neuropathic pain score (NPS) score. The patient satisfaction was noted at baseline, 4 weeks, and 8 weeks. Patients were followed up for 3 months to assess the increase or decrease in hyperalgesia after stopping PRP. ANOVA was used with the Bonferroni correction for NPS score at various time interval. P ≤ 0.05 is considered statistically significant. Results: Numeric Rating Scale score showed statistically significant improvement at end of the study as compared to the baseline. Patients also had improvement in range of motion which was assessed at every visit. A few patients had mild redness and burning postprocedure which resolved spontaneously after a few hours. Conclusions: From this study, we concluded that subcutaneous PRP shows a significant reduction of hyperalgesia associated with CRPS.

Keywords

• complex regional pain syndrome
• hyperalgesia
• platelet-rich plasma