HYPOTHESIS AND THEORY article
Front. Pain Res.
Sec. Non-Pharmacological Treatment of Pain
Volume 6 - 2025 | doi: 10.3389/fpain.2025.1540930
Additional Evidence from a Case Report Supports a Novel Hypothesis on the Association Between Complex Regional Pain Syndrome and Lymphedema
Provisionally accepted
- 1Mayo Clinic, Rochester, Minnesota, United States
- 2University of Texas Health Science Center at Houston, Houston, United States
- 3Baylor College of Medicine, Houston, Texas, United States
- 4Intellicure, Inc., The Woodlands, United States
- 5Strategic Solutions, Inc., Bozeman, United States
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A previous report of 4 heterogeneous cases demonstrated that automated manual lymphatic drainage therapy (AMLDT), administered by a novel, pneumatic mat of 16 pressurized air channels that inflate and deflate sequentially to mimic the stretch and release action of manual lymphatic drainage therapy (MLD), altered lymphatic contractility and relieved pain. Near-infrared fluorescence imaging (NIRF-LI) was used 1 hour before AMLDT, during 1-hour of AMDLT, and 30-60 minutes after treatment to obtain images that could be used to determine lymphatic contractility, as measured by pulsing frequency over a given timeframe. Herein, a case of type 1 complex regional pain syndrome (CRPS, with nerve dysfunction confirmed) and lymphedema following a complex fracture on the lower leg is reported in further detail, with a discussion explaining the association between autonomic and lymphatic dysfunction and their combined contribution to the development of chronic pain. More specifically, this case provides clinical evidence of the association between autonomic nervous system dysfunction, lymphatic dysfunction, and CRPS. We believe that the regulation of lymphatic flow is a potential therapeutic pathway to alleviate the symptoms of CRPS. Further research on the association between autonomic and lymphatic dysfunction and pain is warranted, particularly in patients with CRPS and symptoms of edema following leg fractures.
Keywords: Manual lymphatic drainage, Automated MLD Therapy, complex regional pain syndrome, autonomic dysfunction, Lymphatic dysfunction, Lymphatic contractility, Pain, Near-infrared Lymphatic Imaging
Received: 06 Dec 2024; Accepted: 11 Jun 2025.
Copyright: © 2025 Melin, Aldrich, Karni, Fife, Eckert and Rasmussen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: John C. Rasmussen, University of Texas Health Science Center at Houston, Houston, United States
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