Peripheral Neuromodulation: Type 2 Complex Regional Pain Syndrome Secondary to an Excisional Biopsy

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. 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. The European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) questionnaire was used as tool during an 18th month period follow-up. 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 18 months, a progressive reduction of pain medication and an improvement in her quality of life associated with a remarkable relief in pain, allodynia, and temperature impairment was achieved. Given its high acceptance, safety, and potential to influence neuronal plasticity, WPNS thus shows to be a promising and favorable tool in the multidisciplinary approach of CRPS.