Immunomodulation as a Treatment for Complex Regional Pain Syndrome (CRPS)

The cause of complex regional pain syndrome (CRPS) has been a mystery to medical professionals for many years. While many unknowns still surround CRPS, researchers believe that an autoimmune component may be involved. This means that CRPS may, at least in part, be caused by the immune system mistakenly attacking healthy cells. With this realization, immunomodulation is a possible treatment option for CRPS.

Immunomodulation therapy aims to change the action of the immune system, either by suppressing it or enhancing it. An immunomodulator is a substance that works to regulate the immune system. Examples of immunomodulators include immunoglobulins, monoclonal antibodies, and glucocorticoids.

Because research suggests that the immune system may play a part in the development of CRPS, immunomodulators may help reduce inflammation, pain, and other CRPS symptoms. These treatments may be especially effective for individuals with CRPS who have increased levels of proinflammatory cytokines, which are regulators of inflammation.

Immunomodulators that may be beneficial for individuals with CRPS include the following:

• Tumor necrosis factor-alpha (TNF-α) inhibitors reduce inflammation and may help reduce pain, improve motor function, and regulate temperature in the affected limb. These benefits may be more noticeable in individuals with acute CRPS than chronic CRPS.
• Thalidomide has immunomodulating properties and may help relieve CRPS pain and improve function of the affected limb.
• Immunoglobulins are antibodies that are produced by the plasma in the blood. Immunoglobulin replacement can be used as immunotherapy. For individuals with CRPS, it may reduce pain intensity. Immunoglobulins are often administered via IVIG therapy.
• Glucocorticoids, a class of corticosteroids, work with the body’s immune system. They can reduce the signs and symptoms of CRPS. Oral glucocorticoids may be more beneficial than injectable glucocorticoids.

More research and studies involving immunomodulation therapy for CRPS are needed. However, it is a promising treatment option for individuals with pain and other symptoms related to CRPS.

Additional sources used to create this article include the Stem for Life Foundation and the Reflex Sympathetic Dystrophy Syndrome Association (RSDSA).