Complex Regional Pain Syndrome

Question 1

when does it develop?

Answer 1

after trauma or disuse

Question 2

Type 1

Answer 2

• AKA reflex sympathetic dystrophy
• presents with intense pain throughout the limb but does not involve specific damage to peripheral nervous system
• most common

Question 3

Type 2

Answer 3

• AKA Causalgia
• involves specific damage to the peripheral nervous system, typically resulting in both overt motor and sensory neuropathic sxs

Question 4

Signs and symptoms

Answer 4

• diffuse and intense pain
• continuous burning or throbbing pain
• hyperalgesia and allodynia
• decreased movement of affected area
• cold sensitivity
  -edema in painful area
• change in skin temp, color, texture
• hyperhidrosis
• changes in hair and nail growth
• atrophy and risk of osteoporosis

Question 5

Diagnosis

Answer 5

• must distinguish between types
• use body chart, neuropathic pain questionnaire, and focused NM exam to determine type 2
• nerve conduction/EMG also helpful if pt cannot move

Question 6

treatment

Answer 6

• NSAID, corticosteroids, anti-seizure, anti depression, ketamine, opioid, lidocaine patches
• sympathetic nerve block
• spinal cord stimulation
• CBT

Question 7

PT for CRPS

Answer 7

• movement is critical
• Typie 2 may requires more passive/AAROM and splinting
• desensitization training of affected area
• aerobics
• manual therapy, modalities
• pain ed