Identification and Treatment of New Inflammatory Triggers for Complex Regional Pain Syndrome: Small Intestinal Bacterial Overgrowth and Obstructive Sleep Apnea

Leonard B. Weinstock, Trisha L. Myers, Arthur S. Walters, Oscar A. Schwartz, Jarred W. Younger, Pradeep J. Chopra, Anthony H. Guarino

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Complex regional pain syndrome (CRPS) is evoked by conditions that may be associated with local and/or systemic inflammation. We present a case of long-standing CRPS in a patient with Ehlers-Danlos syndrome in which prolonged remission was attained by directing therapy toward concomitant small intestinal bacterial overgrowth, obstructive sleep apnea, and potential increased microglia activity. We theorize that cytokine production produced by small intestinal bacterial overgrowth and obstructive sleep apnea may act as stimuli for ongoing CRPS symptoms. CRPS may also benefit from the properties of low-dose naltrexone that blocks microglia Toll-like receptors and induces production of endorphins that regulate and reduce inflammation.

Original languageEnglish
Pages (from-to)272-276
Number of pages5
JournalA & A case reports
Volume6
Issue number9
DOIs
StatePublished - May 1 2016

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