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MSK III & IV > Complex Region Pain Syndrome > Flashcards

Complex Region Pain Syndrome Flashcards

1
Q

Complex regional pain syndrome is chronic _______ pain that follows limb injury; pain lasts longer and _________ for the original tissue damage

A

neuropathic pain
More severe than expected

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2
Q

Does complex regional pain syndrome affect both upper and lower extremities?

A

yes both UE and LE but more common for UE

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3
Q

CRPS is related to what 4 injuries

A
  1. crush injuries
  2. distal radius fracture
  3. Tibial fracture
  4. traumatic peripheral nerve injuries
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4
Q

CRPS without major nerve damage (pain syndrome triggered by a soft tissue or bone injury not associated with an identifiable nerve injury)

A

Type 1

often a crush injury particularly in lower limb
following immobilization
may also follow an ampuation

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5
Q

CRPS with major nerve damage (pain syndrome involving direct partial or complex injury to a peripheral nerve

A

Type 2

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6
Q

Warm CRPS

A

warm, dry
Red
Edematous
shorter in duration

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7
Q

Cold CRPS

A

cold, blue
sweaty
less edematous
20 months duration

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8
Q

Which type of CRPS is more common

A

Type 1 with out nerve damange

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9
Q

Is CRPS more common in men or women

A

women x3

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10
Q

what is the mean age for CRPS?

A

46-52

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11
Q

unusual increased or altered sensitivity to sensory stimuli

A

hyperesthesia

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12
Q

Increased sensitivity to pain

A

hyperalgesia

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13
Q

Condition in which ordinarily non-painful stimuli evokes pain

A

allodynia

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14
Q

CRPS diagnosis criteria: patient symptoms

A

continuing pain disproportionate to inciting event
AND
symptoms in 3 of the 4 categories
sensory: hyperesthesia and/or allodynia
Vasomotor: temp changes/skin color changes/ skin color asymmetry
edema: edema/sweating or sweating asymmetry
motor: decreased ROM or motor dysfunction or trophic changes

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15
Q

PT must have continuing pain disproportionate to inciting event and symptoms in 3 of 4 categories

A

sensory
vasomotor
edema
motor/trophic

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16
Q

CRPS diagnosis criteria physical exam findings

A

physical exam: must have at least 1 sign at time of evaluation in 2 or more categories
sensory: evidence of hyperalgesia/ allodynia
vasomotor: evidence of temp changes or skin color changes
edema: evidence of edema or sweating changes
Motor: evidence of decreased ROM or motor dysfunction

17
Q

CRPS diagnosis criteria

A
  1. Patient symptom criteria met
    (3 out of 4)
  2. provider examination criteria met
    (2 or more)
  3. no other diagnosis that better explains signs and symptoms
18
Q

what is that pathophysiology of CRPS

A

somatosensory system
-changes that process thermal, tactile and noxious stimuli

19
Q

4 categories of pathophysiology of CRPS

A
  1. central sensitization
  2. peripheral sensitization (increased firing)
  3. release of neuropeptides
  4. altered sympathetic nervous system
20
Q

Vasoldilation- warm/red extremity
increased local, system and cerebrospinal fluid levels of pro-inflammatory factors
decreased systemic anti-inflammatory factos

Related to acute or chronic CRPS

A

Acute CRPS- reduced SNS function

21
Q

Vasoconstriction- cold/bluish extremity
super- sensitivity to catecholamines- may lead to exaggerated sweating and vasoconstriction
vasoconstriction may contribute to trophic changes due to local tissue hypoxia
Related to acute or chronic CRPS

A

chronic CRPS- increased SNS function

22
Q

what are some psychological factors that may be present in CRPS

A

emotional arousal–> greater pain intensity
stress–> altered immune function

23
Q

True/false: treatment for CRPS must include PT, pain control, psychotherapy

A

True

24
Q

PT interventions for CRPS

A
  1. minimize pain
    DO NOT IMMOBILIZE
  2. modalities
  3. Edema Control
  4. Desensitization
  5. gentle AROM/PROM
  6. tendon gliding
  7. mob upper thoracic spine
  8. aerobic exercise
  9. pool therapy
25
Q

restoration of brains concept of left and right
conscious access to area of brain involved in intention/preparation/carrying out movement
brain is tricked into thinking that limb is better than it thinks it is

A

graded motor imagery
mirror therapy

26
Q

Scrubbing/carrying
weight can be adjusted by body position
Force and duration parameters can be altered based on patient response

For LE:
gradual increase in wbing
walking

A

stress load program

27
Q

address work-related activities and assists with return to work program

A

vocational rehab

MSK III & IV (10 decks)

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