How to treat complex regional pain syndrome?

  Ten years ago, unintentionally old Yu’s right wrist suddenly appeared pain, they went to seek medical treatment, after being recommended he found an old army doctor, the old doctor told him suffering from “tendovaginitis”, is a common disease, a shot will be cured. “After all, it is an old expert, so far I remember it, it cost 57 yuan, really cured.” The old Yu’s occupation is a plier, work often need to use the wrist force, perhaps because of the work, two years later the wrist pain problem again. So he went to the old military doctor again, unfortunately the old military doctor has died, so he had to ask other doctors to treat, the same needle twice, but the pain is not good at all. Therefore, this doctor also advised him to find another doctor.  During the next ten years, he went to the most famous general hospitals and specialized hospitals in the field of neurology and orthopedics, and even became “acquaintances” with the specialists of these hospitals. During his treatment, he had no less than five incisions on his right forearm, and the surgical scars extended from the outside of his elbow fossa to his right thumb, which was alarming to the eyes.  After five open surgeries, numerous local injections and invasive treatments such as radiofrequency, Yu’s arm was scarred.  In addition eaten countless Chinese and Western medicines, used unimaginable strange prescriptions, even once with ginger, garlic, chili peppers, spirits and other irritating food crushed for external use, resulting in the entire right hand burns, the back of the hand still remains after the burn marks.  ”I’m not going to hide from you, the one in my family (Lao Yu’s wife) even invited me to Daxian, jumped over the Great Spirit. Nothing worked.” Despite trying so many methods, the condition did not lessen, but got worse, and the pain developed from the wrist to the whole arm. Long-term pain led to a big change in his temperament, “at home, I can’t even sit for 5 minutes, and I can’t even help losing my temper with my 3-year-old grandson; outside, with the old guys are also talking about 5 minutes of pain on the fire, and the pain I have to keep the hand on the end of the hand that hurts, over time, people send nickname ‘a hand ‘.”  The pain not only made the quality of life of the old Yu extremely reduced, but also deprived him of sleep. During this decade, most of the time, Lao Yu can only sleep about 2-3 hours a day, but also in the premise of taking 2-3 times more than adults analgesics and sleeping pills, “so I can clearly feel that my gastrointestinal function and kidney function has significantly decreased over the past few years.” He said.  ”In fact, I have moved to die more than once in the past few years, but I still have to live my life, and I still have to treat the pain. No matter which hospital I go to, I always tell the doctor that you are free to treat this arm, and I don’t blame you if it’s disabled, as long as it stops the pain.” But after ten years of treatment, the flesh on the arm is open and grows again, grows well and opens again.  ”I had already given up, but by chance I heard from a friend that Dr. An Jianxiong, director of the Pain Medicine Center of the Aviation General Hospital of China Medical University, is unique in pain, especially for nerve pain, which is the best. One of his acquaintances had herpes zoster neuralgia (commonly known as “waist wrapping dragon”) and was cured by Dr. An Jianxiong. My family member also persuaded me to take a look, in case it works. That’s how I found Professor An Jianxiong.” Director An Jianxiong told Lao Yu with conviction that his pain was caused by radial nerve injury, but after so many times of various treatments it was not only the problem of “tendinitis”, but first of all, all invasive treatments should be stopped, and repeated invasive treatments without selection will break even good people. “Your disease is more complicated, but can be treated, first stay, we give you a good study. Then set a treatment plan.” Hearing the words of director An Jianxiong, who was not sure but responsible, Lao Yu, who had experienced so many “big worlds” and big hospitals, stayed in the hospital with confidence.  The walls of the outer corridor were no longer filled with the usual rigid “science” advertisements produced by pharmaceutical companies, but with letters of appreciation written by the cured patients themselves, as well as papers published by the doctors of the department in The walls are no longer filled with the usual rigid “science” advertisements produced by pharmaceutical companies, but with thank-you letters written by patients from all over the world, as well as papers published by doctors in American medical journals. When Yu read one of the patient’s letters of appreciation, he was greatly encouraged to overcome his illness. This woman, Lou, from Shandong Province, who grew cherries for a living, suffered from nerve damage that caused unbearable pain in her feet like burning charcoal, and had to put her feet in cold water every night, no matter it was cold or hot. Later, after half a month of careful treatment by Director An Jianxiong, she made a miraculous recovery, and the whole family was back to normal! And when he saw that the wall of the ward was hung with the motto of “the highest principle is to do no harm to the patient” and “only use the method that you or your loved ones are willing to accept for the patient”, his apprehensive heart gradually dropped.  After discussions between Director An Jianxiong and the pain center team of multidisciplinary experts, it was concluded that Lao Yu’s condition was not just a simple radial nerve injury, but a complex regional pain syndrome (CRPS) caused by nerve injury. CRPS is neuropathic pain and, like post-herpetic neuralgia, is one of the most difficult pain disorders to manage. Since the early 1990s, Jianxiong An has been working on these two disorders under the guidance of one of the most renowned pain scientists in China, and then traveled across the world to study and work for five years at Churchill Hospital in Oxford, England, St Thomas & Guy’s Hospital in London, and the University of Pittsburgh in the United States. After returning to China in 2005, Director Jianxiong An formed a new team and continued to explore the establishment of an animal model of neuropathic pain until 2011, when the results of this work were finally published in one of the world’s earliest analgesic journals (1942) published in the United States. It took 20 years from the conception of this model to its publication!  In 2012, Jianxiong An’s team moved to the Aviation General Hospital of China Medical University, and President Gao Guolan, who was once the president of the university, with the unique vision of an educator and a medical doctor, made full use of this team to create a “comfortable medical treatment and pain-free hospital”, and at the same time established the Postherpetic Neuralgia Research Unit of the Institute of Translational Medicine of the Chinese Academy of Sciences in Beijing. Based on the strong life science foundation of the Chinese Academy of Sciences, the research laboratory uses the world’s most advanced concepts, technology, imaging and other equipment, and applies the latest research results to clinical practice. In just two years, the laboratory has reached the international leading level in the field of postherpetic neuralgia treatment. Combined with clinical needs, Jianxiong An’s team also conducted targeted experimental animal studies and discovered for the first time in the world that an important cause of neuralgia caused by peripheral nerve injury is structural changes in the central nervous system, that is, the brain and spinal cord, which overturned the traditional doctrine that neuralgia is a result of so-called plasticity of the central nervous system, that is, non-structural changes, and that it is possible, with appropriate intervention, to Both central and peripheral structural damage and pain can be recovered through proper intervention.  After discussion, Director Jianxiong An decided to give Lao Yu neurotrophic repair therapy, which abandoned the destructive treatment methods such as blocking and destroying the nerves in the painful area, and is an application of image guidance to nourish, regulate and repair the peripheral and central nerves through precise interventions. The entire treatment process does not use a single drop of hormone, which is almost mandatory for the treatment of pain. In this way, the side effects and harm caused by the treatment method to patients are minimized. Director An Jianxiong believes that the human body is particularly amazing and cannot be mechanically treated where the pain is and where the disease is, which will not only fail to achieve good treatment results, but may also be counterproductive and make the patient’s condition worse.  With rich theories and scientific research as the foundation, supported by rich clinical experience, choosing the right path, you can get twice the result with half the effort. After two treatments, there was a noticeable change in Lao Yu’s condition. “My arm has never been so good since I did the treatment today until eight o’clock at night. After eight o’clock there is some pain, but it can be controlled with oral medication.” That night he informed Director An Jianxiong of the good news by text message. As the treatment progressed, the changes in Lao Yu’s condition were more and more obvious.  Even the patients said, “Yo, Lao Yu, you didn’t sleep at 2:00 or 3:00 every night during the first two days of hospitalization, but you’re sleeping earlier and earlier these two days, and it’s not even 10:00 today!  ”You do not know, before that is the pain ah, you think I would like every day like a night owl do not sleep ah, the original is to eat the painkillers can not stop ah!” Old Yu replied happily.  A few days ago, tormenting the old Yu ten years of pain has basically disappeared, the old Yu half-heartedly admitted to the hospital, the unexpected harvest healed home.