This page endeavors to explain the components of the TREND methodology and how they interact and are utilized to better understand the disorder of CRPS. This diagnostic tool is most prevalent in use in the Netherlands, although it is being more utilized recently in Germany, the United Kingdom, and the United States. The methodology has proven to yield impactful results in the understanding and treatment of Complex Regional Pain Syndrome (CRPS) both in the United States and abroad.
- TRIALS – clinical trials are mainly conducted by national laboratories such as the NIH. These studies have followed patients for as many as 15 years and have been a significant part of the research into best practices for understanding and diagnosing the disorder as well as finding the mot efficacious treatments. CRPS is an acute pain syndrome and, as such, does also have a psychology component tot he research and treatment of this syndrome. Tactile discrimination training has been utilized in some trials with success. This treatment has not yet been studied in a blind trial, but finial results have proven promising.
- EPIDEMIOLOGY – the epidemiology of CRPS can present in many different forms, and diagnosis can often be missed completely or delayed. Control groups have been used to better understand the affliction as well as instances where a traumatic injury to a limb does not result in the onset of CRPS. Researchers have found it notable that the instances of occurrence in younger patients is increasing. Spinal cord stimulators utilize a device that is surgically implanted to interrupt the transmittal of pain and has proven to be effective treatment for chronic pain sufferers, including those afflicted with CRPS.
- BIOMARKERS – the instances of certain anomalies in the central nervous system, such as microneurography, are being used in CRPS research to better understand how these markers can provide insights into how this disorder spreads to other limbs, why it presents after some traumatic limb injuries and not all, and how pain communicators can be disrupted. Utilizing mirror visual feedback, some patients have found success in rewiring the faulty neurotransmitters in order to circumvent pain receptors.
- GENETICS – CRPS presents more in females than in males, with the greatest instance occurring in patients in their early 40s. Genetic indicators are studied to better understand the relationship between the finial injury, the onset of the disorder, its duration and severity, and whether or not other limbs will be affected. The spread of the affliction to other parts of the body, as well as organs, can sometimes require amputation and quick diagnosis provides the best hope for effective treatment. The genetic disposition of the patient, and their ability to heal from the initial trauma, are quite impactful because if the wound does self-heal without direct treatment, a swift diagnosis is less likely. There is still a lack of clarity around why some injuries appear to heal and then CRPS symptoms appear, researchers continue to pursue the genetic relationship to this phenomenon.
- ASSESSMENT – all of the above factors are considered in the final assessment and conclusions reached in each study. The assessment phase of the TREND methodology provides the linchpin of the research and data gathering. This assessment will pull together all of the previously conducted steps in the methodology and distil them to usable data points that direct the path of further research. Research stresses that a prompt diagnosis of the disorder, ideally before three months have elapsed from the initial injury, it pivotal.