A Case of Truncal Complex Regional Pain Syndrome, literature review

Abstract

Introduction and importance: Complex regional pain syndrome (CRPS) is a rare and chronic pain disorder characterized by an abnormal level of pain disproportionate to the initiating cause, often manifesting well after the triggering event. Case presentation: We present a free past medical history 33-year-old female, employed as a nurse in an intensive care unit, presented with a nine-year history of diffuse back pain. Her symptoms initially emerged at the neck with muscle spasms and restricted neck mobility, eventually progressing along the spine. Notably, the pain became episodic and intensified over time, significantly impeding her daily activities. Analgesic (non-steroidal anti-inflammatory drugs) treatments proved ineffective, and a distinct feature emerged—a change in skin color to dark purple spots on her back, accompanied by hyperhidrosis and extreme tenderness. Despite an exhaustive evaluation involving blood work, inflammatory markers, serological tests, and radiographic imaging, a definitive diagnosis remained elusive until she responded positively to Pregabilin. Clinical discussion: Although typically associated with extremities, this case challenges the conventional understanding of complex regional pain syndrome (CRPS) by showcasing its manifestation in the truncal region. The patient’s clinical history, examination findings, and diagnostic journey are detailed herein, shedding light on the complexity and diagnostic considerations associated with this condition. Conclusion: The case underscores the importance of a comprehensive approach and prompts a reevaluation of the existing guidelines to encompass such atypical presentations.