Peripheral neuromodulation: Type 2 Complex Regional Pain Syndrome secondary to an excisional biopsy

Background: Complex Regional Pain Syndrome (CRPS) is a multifactorial and often refractory condition that involves hyperalgesia and allodynia of the extremities. Current treatments are mostly limited and short-lived, thus different modalities of interventional pain control, have come up to play a significant role in the management of CRPS. Objectives: The aim of this article is to present a single case from a Multidisciplinary Pain Management Center, regarding a wireless peripheral nerve stimulation (WPNS) treatment for a type II CRPS. Methods: The EORTC QLQ-C30 and NHP questionnaires were used as tools, during an eighteenth month period follow-up. Results: A 43-year-old healthy woman, diagnosed with ganglionar tuberculosis and a refractory type II CRPS in the right upper extremity, following an excisional biopsy. She underwent placement of a permanent electrode in the right ulnar nerve. During eighteen months, a progressive reduction of pain medication was also achieved and an improvement in her quality of life associated to a remarkable relief in pain, allodynia and temperature impairment. Conclusions: Given its high acceptance, safety and potential to influence the neuronal plasticity, WPNS thus shows to be a promising and favorable tool in the multidisciplinary approach of CRPS.