Introduction
Complex regional pain syndrome (CRPS) is a debilitating neuropathic
disorder marked by persistent pain disproportionate to inciting injury
(1,
2). Though CRPS is often seen in the setting of a traumatic event but
may also occur spontaneously
(3,
4). The pathophysiology of CRPS is likely multifactorial with many
proposed mechanisms present in the literature involving dysregulation in
both the sympathetic and central nervous systems, as well as
contributions from genetic, inflammatory, and psychological factors
(2).
CRPS pain is often accompanied by various other sensory, vasomotor,
sudomotor, motor, or trophic symptoms
(3).
These symptoms significantly impact their quality of life and daily
functioning
(5).
While reports of CRPS’ incidence range from 0.82 to 5.46 per 100,000
person-years
(6,
7). the severe nature of CRPS underscores the need for effective
treatment options.
Treatment for CRPS is often challenging, with many cases proving
refractory to standard therapies
(8).
Conservative treatments typically include physical therapy, occupational
therapy, or psychotherapy, along with medications such as NSAIDs,
antiepileptic drugs (AEDs), antidepressants, and opioids
(8).
However, these medications often carry significant side effects and may
not provide adequate relief for all patients. Invasive options, such as
sympathetic blocks and spinal cord or dorsal root ganglion (DRG)
stimulation
(8),
are available but bear risks associated with interventional procedures.
As a result, there is a growing need for alternative approaches,
particularly for patients who wish to avoid or have not benefited from
conventional medications or interventional procedures.
Recent interest in the role of psychedelics in pain management has
prompted exploration into their potential use for CRPS
(9).
This case report describes the experience of a 54-year-old female with
CRPS and her use of psilocybin as a treatment. To our knowledge, this is
the second case report suggesting the potential efficacy of psilocybin
for managing CRPS symptoms.