- Background and aims

CRPS is a painful and incapacitating pathology, whose symptomatology exceeds the initial lesion in magnitude and duration, and can produce an important functional deterioration. In 60-75% of the cases there is a history of a previous traumatic injury in members, as in this case.

- Methods

A 36-year-old patient who, after a matricectomy of the first toe of the right foot, presented hyperalgesia, temperature changes, edema, reticular livedo in episodes of paroxysmal pain, and decreased degree of movement of the right foot. For walking, he needs the help of a cane.

At first, it is treated in rehabilitation with physiotherapy and pharmacological treatment, improving mobility, hyperalgesia and edema but without achieving lesional stability, which is why it is referred to the unit of pain.

When the patient arrives at our surgery, the patient presents a stabbing and disabling pain on the outer surface of the first toe with hyperalgesia. We performed infiltration with local anesthetic and corticosteroids of the medial dorsal cutaneous nerve, pulsed radiofrequency of said nerve and 8% capsaicin patch.

- Results

The patient can walk without a cane and the intensity of the seizures has diminished, as well as the frequency.

- Conclusions

The lack of knowledge of the etiopathogenesis of this syndrome, the complexity and temporal variation of the signs and symptoms that constitute it, make it necessary an early diagnosis suspicion. From the beginning, a multidisciplinary treatment should be established to control pain, treat psychological alterations, improve vasomotor alterations, avoid stiffness and osteoarticular sequelae.

COMPLEX REGIONAL PAIN SYNDROME AFTER MATRICECTOMY OF THE FIRST TOE