Mainz University Medical Center searches for treatment for posttraumatic pain syndrome

German Research Foundation funds a three-year joint project of the Mainz University Medical Center and the University of Münster to the tune of about €460,000

02.10.2012

The work group "Pain – Autonomic Nervous System" headed by Professor Dr. Frank Birklein of the Department of Neurology at the Mainz University Medical Center and the collaborating research team of bioanalyst Professor Dr. Simone König of the University of Münster have been granted funding of approximately EUR 460,000 by the German Research Foundation (DFG) to conduct research into the complex regional pain syndrome (CRPS). This syndrome is a posttraumatic pain disorder that some 5 percent of patients develop after an injury, such as a bone fracture. These patients exhibit exacerbated inflammatory reactions in the affected limbs, the symptoms of which include hyperthermia, edema, excessive sweating, and pain on movement. The aim of this three-year joint research project is to study the inflammatory processes in the tissue and thus develop a rapid, targeted, and individually tailored treatment for CRPS.

If, several weeks after suffering an injury or an accident or undergoing surgery to arms or legs, the patient continues to have severe and persistent pain coupled with vegetative symptoms in the affected extremities for which there is no apparent cause, it is often the case that this individual is suffering from what is known as the complex regional pain syndrome (CPRS, also called Sudeck's atrophy). In such cases, the pain does not subside as expected after a relatively minor injury such as bruising or a sprained ankle or following surgery. Instead, the pain becomes more severe and other symptoms develop, such as swelling, temperature changes of the skin, increased hair and nail growth, and restriction of movement and functions. If there are nerves that were damaged by the original injury, the condition is called complex regional pain syndrome type II (CRPS II). It is estimated that about 5,000 to 10,000 patients in Germany are affected annually, among them significantly more women than men. Most patients are in the age range of 40 to 60 years.

The mechanisms underlying this disorder are still not understood so treatment is fairly non-specific. The diagnosis can often only be made by the process of elimination. On the other hand, CRPS detected at an early stage can be cured. The earlier treatment begins, the better the chances of recovery. The illness is currently treated by a multimodal treatment approach, which usually involves a combination of drug treatment, physiotherapy, and psychotherapy.

During the research project, the researchers at the Medical Center of Johannes Gutenberg University Mainz will be studying how and why the inflammatory processes occur in the tissue in CRPS and in particular why they do not disappear when the wound has physically healed. The researchers of Birklein's work group in the Department of Neurology at the Mainz University Medical Center along with their national and international cooperation partners around the world have published most of the medical articles on the topic of CRPS so far and have already made important progress towards describing and detecting the inflammation associated with CRPS. "If we want to be able to develop targeted individual treatments, we first need to find the answer to the question of 'Why?'. We hope that we will obtain the necessary information in this research project," says Professor Dr. Frank Birklein.