Can DRG stimulation improve social and physical function in CPRS 1 of the knee? A case report

Mariateresa Giglio, Alberto Corriero, Ermanno Arcamone, Angela Preziosa, Filomena Puntillo. Neuromodulation 2025; 28(1):S280. DOI: 10.1016/j.neurom.2024.09.42

Abstract

Complex regional pain syndrome (CRPS) is a debilitating condition characterized by a continuing (spontaneous and/or evoked) regional pain that is seemingly disproportionate in time or degree to the usual course of any known trauma or other lesion, associated with abnormal sensory, motor, sudomotor, vasomotor and/or trophic findings. CRPS 1 lacks nerve injury while CRPS 2 has evidence of it. The diagnosis is clinical, basing on the Budapest Criteria. Several mechanisms have been implicated in CRPS, such as inflammation, altered cutaneous innervation, sympathetic nervous system, changes in circulating catecholamines, autoimmunity, brain plasticity, genetic effects and psychological influences. Therefore, CRPS treatment can be a very difficult challenge. Oral medications, topical treatment, intramuscular bisphosphonates, intranasal calcitonin, and recently botulinum toxin type A, with psychotherapy and functional restoration are utilized. Invasive treatment options for CRPS include spinal cord stimulation (SCS) and dorsal root ganglion stimulation (DRG). Recent evidence suggests that DRG stimulation may be more effective for lower limb CRPS in terms of pain reduction and quality of life. The aim of the present case report is to underline the beneficial impact on pain and function of DRG stimulation in a case of CPRS 1 of the knee.