Spinal cord stimulation (SCS) has been reported to be effective for complex regional pain syndrome (CRPS). This is a case report of a patient with CRPS who was successfully treated with a combination of temporary SCS lead placement and physical therapy. A 19-year-old man presented with severe pain for a few months since receiving plaster cast fixation as treatment for an ankle sprain injury at the previous hospital. At his first visit to our pain center, he could not walk without crutches because of severe pain accompanied by symptoms such as allodynia, decreased skin temperature, redness, edema, muscle weakness, and changes in the appearance of the affected area. The symptoms met the diagnostic criteria for CRPS. Temporary SCS lead placement was performed to alleviate the pain and peripheral circulatory disorder, along with physiotherapy to improve the flexibility and restore the normal appearance of the affected limb. The interdisciplinary treatment effectively improved our patient's leg edema and walking ability, which consequently led to pain relief.
This case report describes the effect of exercise therapy on a patient with plasmacytoma diagnosed with chemotherapy-induced peripheral neuropathy (CIPN). A man in his mid 70s was diagnosed with plasmacytoma and received outpatient chemotherapy. He developed glove-and-stocking numbness and balance disorder and underwent 16-week multimodal exercise therapy consisting of resistance and balance training, and aerobic exercise. He attended one session per week of exercise therapy at a hospital under the supervision of a physical therapist and completed five sessions of home-based exercise. His symptoms and physical function were evaluated at baseline and after intervention using the Common Terminology Criteria for Adverse Events version 5.0 (CTCAE), Functional Assessment of Cancer Therapy-Neurotoxicity subscale (FACT-Ntx), modified Total Neuropathy Score (mTNS), Stand-up test, and Berg Balance Scale (BBS). After the 16-week intervention, clinician-assessed CIPN symptoms were stable (CTCAE：Grade 2 at baseline, Grade 2 after intervention), whereas patient-reported CIPN symptoms improved beyond the minimal clinically important difference (FACT-Ntx score increased from 22 to 29 points). Although the components of mTNS such as motor symptoms and strength improved, the total mTNS score remained stable. The Stand-up test and BBS scores improved, and better physical function led to improvements in activities of daily living. Thus, exercise therapy may effectively reduce the symptom burden and improve physical function in patients with CIPN.