Editor-in-Chief: Alaa Abd-Elsayed, MD, PhD

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  1. 2021;5;109-113 Management of Pediatric Complex Regional Pain Syndrome with Low-Dose Naltrexone
    Case Report
    Amol Soin, MD.

BACKGROUND: Complex regional pain syndrome (CRPS) is a chronic, orphan neurologic condition that affects the extremities after nerve trauma or injury. Management of CRPS can be challenging due to a paucity of evidence surrounding treatment options. Low-dose naltrexone (LDN) has been used for the management of other types of chronic pain. LDN is believed to exert its activities through inhibition of Toll-like receptor 4, which attenuates microglial activation. This case report describes the use of LDN in an 11-year-old boy with CRPS.

CASE REPORT: Prior to initiating LDN, this patient was treated with gabapentin and amitriptyline, which were associated with undesirable adverse effects. Initiation of LDN allowed for successful discontinuation of gabapentin and amitriptyline. With LDN treatment, the patient’s pain severity improved by 70%, and self-reported functional status improved by 60%.

CONCLUSION: This case report adds to the growing body of evidence that suggests LDN is an effective treatment for chronic pain.

KEY WORDS: CRPS, pain, naltrexone, chronic pain, limb pain