Complex Regional Pain Syndrome (CRPS) is an often debilitating condition, resulting in severe pain and other highly unpleasant symptoms, generally following limb trauma. In around 85% of those who suffer from it, some level of improvement is experienced within 12 to 24 months. However, 15% of people who develop CRPS do not obtain any relief and are left with the intrusive symptoms indefinitely.
The cause of CRPS remains largely unknown and as a consequence there has not been a consistent method of treating the condition, much to the despair of sufferers. The only thing that can be said for certain is that established CRPS is difficult to treat. For many sufferers, medication has little if any effect, and even more invasive treatments such as Spinal Cord Stimulation (SCS) can produce disappointing results.
Recently, however, following clinical trials under the lead of Dr Andreas Goebel, Senior Lecturer in Pain Medicine at Liverpool University, it seems that low-dose immunoglobulin treatment may significantly reduce pain from longstanding CRPS.
Patients suffering with moderate to severe CRPS for between one and five years were randomly selected to be injected with either small amounts of immunoglobulin, a protein produced by antibodies, or a placebo.
Early results are encouraging, with patients given the immunoglobulin reporting reduced pain at the affected site. This would suggest that CRPS is an inflammatory or autoimmune condition, caused by a biological stimulus. Whilst it is not yet understood exactly why or how CRPS is being caused, it seems that patients with CRPS appear to display an increased level of antibodies directed against their own nerves (autoantibodies). Accordingly, CRPS could be due to a reaction of the immune system against the body. Whether or not this is the cause of CRPS or simply one element to it is yet to be seen.
A larger scale clinical trial (known as the LIPS Study) is underway to investigate whether low-dose intravenous immunoglobulin is effective in reducing pain in sufferers of CRPS over a 2 ½ year period. The results are likely to be published in mid-2016. These results may radically alter the way in which CRPS is considered as a condition by the medical world at large, and also the way in which the condition is treated.