CRPS – Is A Protocol Near?

By Ed Coghlan

For people who suffer from CRPS there may be some hope on the horizon.

Up to 50 physicians are expected near Chicago on October 22 for a day-long meeting that the CRPS community hopes results in a protocol to use ketamine to treat CRPS.

“Patients are quite desperate,” said Dr. Peter Moskovitz, a board certified orthopedic surgeon who is chair of the RSDSA. “This meeting in Chicago is important to create a real starting point in getting agreement on how to use ketamine to treat CRPS.”

Complex regional pain syndrome (CRPS) is a chronic pain condition most often affecting one of the limbs (arms, legs, hands, or feet), usually after an injury or trauma to that limb.  CRPS is believed to be caused by damage to, or malfunction of, the peripheral and central nervous systems.

“Ketamine has received a new life as an infusion treatment for chronic pain,” said Dr. Moskovitz in an interview with the National Pain Report. “The meeting is attracting physicians and others interested in developing a reference protocol.”

A reference protocol is needed because Dr. Moskovitz said that the current use of ketamine is a “hodgepodge” of different physicians using it in different ways.

Ketamine was developed in 1962 and has been used widely in anesthesia. Over a half century later, it is generic drug, which poses another challenge for serious study. Because it’s a generic, there is no company interested in putting money into a clinical trial. So in a way, these physicians may be starting their own trial or inspiring one.

“It’s been used, at times very successful, for treating neuroinflammaotary pain,” Dr. Moskovitz pointed out.

The goal of the meeting is to develop a consensus. Ideally three things will occur.

  • The agreement and subsequent publication of a reference protocol
  • Provide a summary of the scientific work that has been done
  • Attract proposals for research that can, as clinical trials aim to do, study the safety and efficacy of the treatment.

“Imagine the data we can develop if we get a couple of dozen physicians around the world using the same protocol to treat CRPS patients,” Dr. Moskovitz said.

For Jim Broatch, the long-time executive Vice President of RSDSA this opportunity is important and critical.

“We hope that our faculty and attendees can agree upon a protocol to treat CRPS. The next step is to find a funder to conduct a clinical trial,” Broatch told the National Pain Report. “Ketamine works but insurers too often have refused to pay for it because deem it an experimental therapy.”

Dr. Moskovitz is optimistic that this meeting can result in a difference for how CRPS patients are treated.

“”This has a good chance at succeeding,” he said.

Patients are hopeful too. More on that in a later blog.

Here’s a link to the conference.

Here’s how the NIH describes Complex Regional Pain Syndrome.

By the way, Dr. Moskovitz is a board certified orthopedic surgeon and an active member of the American Academy of Orthopaedic Surgeons. He has achieved distinction in spine care as demonstrated by membership in the North American Spine Society.

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