Clin Exp Rheumatol
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Complex Regional Pain syndrome type I (CRPS-I) is a disease characterised by extreme pain for which no gold-standard treatment exists to date. In recent years a possible role for bisphosphonates in the treatment of CRPS-I has been proposed. These drugs were first used for their effect in decreasing pain in bone diseases in which bisphosphonates act through their antiosteoclastic properties (metastatic disease, Paget disease, myeloma). ⋯ These features probably represent the required conditions by which bisphosphonates might modulate various inflammatory mediators that are upregulated in CRPS-I. Patients in whom a scintiscan is often negative (long-standing disease or a primarily cold disease) could be less responsive to this treatment. With these limitations, bisphosphonates appear to present a therapeutic strategy that has been proven to reliably offer benefits in patients with CRPS-I.