Denying the Truth Does Not Change the Facts: A Systematic Analysis of Pseudoscientific Denial of Complex Regional Pain Syndrome



Bharwani, KD, Kersten, AB, Stone, AL, Birklein, F, Bruehl, S, Dirckx, M, Drummond, PD, Gierthmuhlen, J, Goebel, A ORCID: 0000-0002-3763-8206, Knudsen, L
et al (show 1 more authors) (2021) Denying the Truth Does Not Change the Facts: A Systematic Analysis of Pseudoscientific Denial of Complex Regional Pain Syndrome. JOURNAL OF PAIN RESEARCH, 14. pp. 3359-3376.

[img] Text
2021 11 systematic review of CRPS denying literature.pdf - Published version

Download (711kB) | Preview

Abstract

<h4>Purpose</h4>Several articles have claimed that complex regional pain syndrome (CRPS) does not exist. Although a minority view, it is important to understand the arguments presented in these articles. We conducted a systematic literature search to evaluate the methodological quality of articles that claim CRPS does not exist. We then examined and refuted the arguments supporting this claim using up-to-date scientific literature on CRPS.<h4>Methods</h4>A systematic search was conducted in MEDLINE, EMBASE and Cochrane CENTRAL databases. Inclusion criteria for articles were (a) a claim made that CRPS does not exist or that CRPS is not a distinct diagnostic entity and (b) support of these claims with subsequent argument(s). The methodological quality of articles was assessed if possible.<h4>Results</h4>Nine articles were included for analysis: 4 narrative reviews, 2 personal views, 1 letter, 1 editorial and 1 case report. Seven points of controversy were used in these articles to argue that CRPS does not exist: 1) disagreement with the label "CRPS"; 2) the "unclear" pathophysiology; 3) the validity of the diagnostic criteria; 4) CRPS as a normal consequence of immobilization; 5) the role of psychological factors; 6) other identifiable causes for CRPS symptoms; and 7) the methodological quality of CRPS research.<h4>Conclusion</h4>The level of evidence for the claim that CRPS does not exist is very weak. Published accounts concluding that CRPS does not exist, in the absence of primary evidence to underpin them, can harm patients by encouraging dismissal of patients' signs and symptoms.

Item Type: Article
Uncontrolled Keywords: complex regional pain syndrome, pathophysiology, treatment, chronic pain
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 15 Nov 2021 09:40
Last Modified: 18 Jan 2023 21:24
DOI: 10.2147/JPR.S326638
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3143184