Photobiomodulation for Complex Regional Pain Syndrome: A Case Report and Literature Summary

Abstract

Complex Regional Pain Syndrome (CRPS) is a highly debilitating chronic pain condition characterized by continuous regional pain disproportionate to duration and intensity of the initial damaging stimulus. In CRPS, abnormal perception, transmission, and modulation of pain by nerve cells and the autonomic nervous system induces extreme increases in perceived pain that may be accompanied by swelling, temperature sensitivity, color fluctuations, and/or skin changes. CRPS most commonly affects the extremities but may spread to other limbs or bodily locations. Since there is currently no cure for the underlying processes that play a role in causing this debilitating condition, therapeutic options seek to mitigate some of the symptoms of CRPS to improve quality of life. A recent systematic review found low-quality evidence of efficacy for all currently available CRPS treatments as well as a lack of consensus about first-line treatments. The pathophysiological complexity of CRPS, in addition to the lack of non-invasive, efficacious therapies for this extremely burdensome pain condition, highlights the vital need to explore novel therapeutic options in both research and clinical practice. Photobiomodulation through the repeated application of high-intensity laser therapy in a clinical setting has been shown to modulate nociception, minimize inflammation, and reduce different types of chronic and acute pain. The present case report describes a clinical protocol using laser therapy for CRPS, presents longitudinal pain scores, and summarizes mechanisms of action supporting the subsequent reduction of CRPS symptoms. After a series of laser treatments, the patient showed marked improvement in range of movement, hypersensitivity, pain, and function. Photobiomodulation through high-intensity laser therapy may represent a promising therapy for individuals affected by CRPS, although further randomized, controlled trials are recommended to evaluate efficacy on different disease-affected areas, assess dose-response relationships, and refine optimal treatment frequency.