Successful treatment of erythromelalgia with intrathecal hydromorphone and clonidine

Abstract

Objective: The objective of this study was to determine if intractable pain from erythromelalgia could be successfully treated with intrathecal hydromorphone and clonidine.

Design: A single case of pain from erythromelalgia refractory to multiple treatment modalities was examined and treated.

Setting: The setting is an outpatient pain clinic at a major university teaching hospital.

Patient: Our patient is an 82-year-old woman with hypertension and peripheral vascular disease.

Intervention: Intrathecal opioid and an alpha2-agonist were administered.

Outcome measures: Outcome was determined by means of patient self-report during office follow-up visits.

Results and conclusions: Administration of intrathecal opioid and an alpha2-agonist can be effective in the treatment of the pain of erythromelalgia and offers an alternative pain treatment modality for patients with unremitting pain refractory to more conservative therapy.