Complex Regional Pain Syndrome: Current Diagnostic and Treatment Considerations

Rand, Scott E.; Basu, Sayantani; Khalid, S.

doi:10.1249/jsr.0000000000000633

Cited by 13 publications

(4 citation statements)

References 35 publications

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“…Sudomotor dysfunction/edema: asymmetry in perspiration, changes in sweating, edema. 4. Motor/trophic dysfunction: limited range of motion (ROM) or motor dysfunction (weakness, dystoni, tremor) or trophic changes (skin, nails, hair) 17,18 Also involved extremity and side; etiological factors (orthopedic surgery history, soft tissue trauma, stroke, immobilization, cast using), possible risk factors (smoking, menopause, migraine, osteoporosis, asthma, anxiety) and used therapeutic modalities were recorded.…”

Section: Methodsmentioning

confidence: 99%

“…1 Etiology is usually related with trauma, fracture, stroke and coronary artery disease. [2][3][4][5][6] Regional inflammation, peripheral and central sensitization are thought to play a role in the pathogenesis of CRPS. 1 This syndrome is characterized by heterogeneous symptoms such as persistent pain, allodynia or hyperalgesia, edema in the painful area, abnormal sudomotor activity disproportionate to the triggering event and changes in skin blood flow are usually seen distally to the involved extremity.…”

Section: Ori̇ji̇nal Araştirma Original Researchmentioning

confidence: 99%

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The Demographic and Clinical Characteristics of the Patients with Complex Regional Pain Syndrome: A Tertiary Clinic Experience

Yilmaz¹,

Demir²

2020

J PMR Sci

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The aim of our study was to determine the demographic and clinical characteristics of the patients with complex regional pain syndrome (CRPS) and to reveal the epidemiological features of CRPS. Material and Methods: Eighty-eight patients with CRPS, admitting to our clinic between January 2010 and December 2018 were included in the study. Patients were evaluated retrospectively in terms of demographics, symptom characteristics (sensory, vasomotor, sudomotor/edema and motor/trophic), involved extremity and side; etiological factors (orthopedic surgery history, soft tissue trauma, stroke, immobilization, cast using), possible risk factors (smoking, menopause, migraine, osteoporosis, asthma and anxiety disorders) and used therapeutic modalities. Results: Mean age of the patients was 51.14±15.25 years (min:18, max: 82). In 60.2% (n: 53) of the patients, upper extremity was involved but there was no statistically significant difference in terms of the involved side (p: 0.754). Soft tissue traumas were the most common factor in etiology in both genders. Most of the patients presented with sensory symptoms. The most common risk factor was menopause in females and smoking in males. Fifty patients (56.8%) had a history of cast using and the mean duration of cast using was 41.60±11.33 days (min: 20 days; max: 70 days). While 63.6% (n: 56) of the patients were included in a physical therapy program; the mean number of the physical therapy sessions was 33.42±10.70 (min: 20 sessions; max: 60 sessions). There was a statistically significant positive correlation between the duration of cast using and the number of physical therapy sessions (r: 0.571, p <0.001). Conclusion: The results of our study suggest that CRPS can affect both genders and different age groups, and that the upper extremity is involved more than the lower extremity. The most common etiological factor is soft tissue traumas. Menopause in females and smoking in males were the two most common risk factors. The determination of the epidemiological characteristics of the patients with CRPS will enable to predict the risky patients and early diagnosis and treatment of the disease.

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Section: Methodsmentioning

confidence: 99%

Section: Ori̇ji̇nal Araştirma Original Researchmentioning

confidence: 99%

The Demographic and Clinical Characteristics of the Patients with Complex Regional Pain Syndrome: A Tertiary Clinic Experience

Yilmaz¹,

Demir²

2020

J PMR Sci

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“…Furthermore, CRPS is extremely debilitating and has significant repercussions on the quality of life of patients [ 10 , 11 ]. The difficulty in understanding its pathophysiology makes both its diagnosis and treatment a demanding task [ 12 ]. The disturbance of the sympathetic nervous system seems to be involved in CRPS [ 13 ] and some symptoms that patients present in the affected limb, such as edema and skin texture or sweating changes, can be compatible with an automatic nervous system dysfunction [ 2 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Quantitative Analysis of Real-Time Infrared Thermography for the Assessment of Lumbar Sympathetic Blocks: A Preliminary Study

Cañada-Soriano

Priego-Quesada

Bovaira

et al. 2021

Sensors

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Lumbar sympathetic blocks (LSBs) are commonly performed to treat pain ailments in the lower limbs. LSBs involve injecting local anesthetic around the nerves. The injection is guided by fluoroscopy which is sometimes considered to be insufficiently accurate. The main aim was to analyze the plantar foot skin temperature data acquired while performing LSBs in patients with complex regional pain syndrome (CRPS) affecting the lower limbs. Forty-four LSBs for treating lower limb CRPS in 13 patients were assessed. Pain medicine physicians visualized the infrared thermography (IRT) video in real time and classified the performance depending on the observed thermal changes within the first 4 min. Thirty-two percent of the cases did not register temperature variations after lidocaine was injected, requiring the needle to be relocated. Differences between moments are indicated using the 95% confidence intervals of the differences (CI 95%), the Cohen effect size (ES) and the significance (p value). In successful cases, after injecting lidocaine, increases at minute 7 for the mean (CI 95% (1.4, 2.1 °C), p < 0.001 and ES = 0.5), at minute 5 for maximum temperature (CI 95% (2.3, 3.3 °C), p < 0.001 and ES = 0.6) and at minute 6 for SD (CI 95% (0.2, 0.3 °C), p < 0.001 and ES = 0.5) were observed. The results of our preliminary study showed that the measurement of skin temperature in real time by infrared thermography is valuable for assessing the success of lumbar sympathetic blocks.

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“…However, CRPS, which is the highest-scoring disease on the McGill pain scale, is still unknown to the public [ 8 ]. Since the pathogenesis of CRPS is yet to be clarified, doctors and researchers have not fully understood the disease [ 9 , 10 ]. This makes it difficult to diagnose and treat the disease.…”

Section: Introductionmentioning

confidence: 99%

Multicenter survey of symptoms, work life, economic status, and quality of life of complex regional pain syndrome patients

et al. 2021

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Background: Complex regional pain syndrome (CRPS) is an intractable pain disease with various symptoms. Here, we investigated the disease status, work life, sleep problems, medical insurance, economic status, psychological problems, and quality of life (QOL) of CRPS patients. Methods: CRPS patients from 37 university hospitals in South Korea were surveyed. The survey questionnaire consisted of 24 questions on the following aspects of CRPS patients: sex, age, occupation, cause of injury, activities of daily living (ADL), pain severity, sleep disturbance, level of education, economic status, therapeutic effect, and suicidal ideation. Additionally, the abbreviated World Health Organization Quality of Life (WHOQOL-BREF) questionnaire, consisting of 26 questions, was used to identify the status of QOL. Results: A total of 251 patients completed the questionnaire. According to the survey, 54.2% patients could not perform ADL on their own. Over the previous week, the mean pain score was 7.15 ± 1.78 (out of a total of 10 points); 92.1% of patients had sleep disorders and 80.5% had suicidal ideation, with most patients suffering from psychological problems. The average for each domain of WHOQOL-BREF was as follows: 21.74 ± 14.77 for physical, 25.22 ± 17.66 for psychological, 32.02 ± 22.36 for social relationship, and 30.69 ± 15.83 for environmental (out of a total of 100 points each). Occupation, ADL, sleep time, therapeutic effect, and suicidal ideation were statistically correlated with multiple domains. Conclusions: Most patients had moderate to severe pain, economic problems, limitations of their ADL, sleep problems, psychological problems, and a low QOL score.

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Complex Regional Pain Syndrome: Current Diagnostic and Treatment Considerations

Cited by 13 publications

References 35 publications

The Demographic and Clinical Characteristics of the Patients with Complex Regional Pain Syndrome: A Tertiary Clinic Experience

The Demographic and Clinical Characteristics of the Patients with Complex Regional Pain Syndrome: A Tertiary Clinic Experience

Quantitative Analysis of Real-Time Infrared Thermography for the Assessment of Lumbar Sympathetic Blocks: A Preliminary Study

Multicenter survey of symptoms, work life, economic status, and quality of life of complex regional pain syndrome patients

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