Plasma Exchange Therapy a Potential Treatment Option for RSD/CRPS Sufferers

Complex Regional Pain Syndrome (CRPS/RSD) has remained a mystery in terms of how to best treat it, but a new, potentially effective treatment known as plasma exchange (PE) therapy gives new hope for those suffering from the chronic pain condition.

study published in Pain Physician looked at PE therapy and found that it may have positive results in certain patients when used in combination with other therapies. The researchers who conducted the study first tried intravenous immunoglobulin (IVIG) treatments in four patients with CRPS/RSD, but only had success with one patient.

Motivated by the idea that CRPS patients sometimes present with symptoms suggestive of a small fiber neuropathy, the researchers began a retrospective case series study involving 33 patients with CRPS/RSD who received PE treatment at Drexel University between September 2012 and June 2014.

After a series of PE therapies performed over a two to three week period, the patients had a pain evaluation, and 30 of the 33 demonstrated a significant pain reduction of 64 percent following the initial PE series. Twenty-four patients are receiving maintenance therapy, and their pain reduction has been maintained with either weekly PE or IVIG, while the remaining six patients did not receive maintenance therapy and their pain has returned to pre-treatment levels.

What is PE Therapy?

Plasma exchange is an extracorporeal therapy involving the extraction of the patient’s whole blood, which is then separated into plasma and blood cells. The plasma is removed and replaced with another solution, such as human albumin in saline or specially prepared donor plasma. The reconstituted plasma substitute, along with the blood cells, is then returned to the patient.

While the researchers acknowledge that large, randomized studies may be required to confirm their results, they are hopeful that such studies may lead to new therapies for this severe, life-altering condition.


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Complex regional pain syndrome (CRPS) is a serious medical condition that causes chronic, debilitating pain. For those who suffer from it more