Complex Regional Pain Syndrome Flashcards
What are 4 primary clinical features of CRPS?
1) Abnormal Pain Processing
2) Skin Color / Temperature Changes
3) Edema, Vasomotor, sudomotor abnormalities
4) Motor Dysfunction and trophic changes
What is the primary cause of the cycle of pain in CRPS?
Disoriented CNS, processing pain in an abnormal cycle
What are the time-frames for Acute, Dystrophic, and Atrophic stages of CRPS?
Acute: 0m to 3-6m
Dystrophic: 3-6m to 12m
Atrophic: >12m
What’s the prevalence % of CRPS following injury, and how many cases are reported each year?
5% may occur after all Injuries
50,000 new cases each year
How do you diagnose CRPS?
At least 1 symptom from each of the main 4 features
+
1 sign in at least 2 subgroups
Usually made by PCP or pain management specialist
What are 3 normal treatment options for CRPS?
Some extreme options?
1) Normalize Movement
2) Pain Control/Management techniques
3) Medications
Extreme Cases:
1) Sympathetic Nerve Block
2) Lumbar Sympathectomy
3) Neurostimulation
4) Intrathecal drug pumps
What are 3 typical signs/symptoms during the Acute phase of CRPS?
Hyperalgesia
Soft localized edema
Affected Limb Warmer
What are 3 typical signs/symptoms during the Dystrophic phase of CRPS?
Constant burning/aching pain
Thick fibrotic edema
Glossy, Sweaty skin
What are 3 typical signs/symptoms during the Atrophic phase of CRPS?
Pain Spreads Proximally
Affected limb Cooler
Cyanotic, Dry skin
What is the typical demographic of patients with CRPS?
42 y/o Women
Women 3x > Men
18-71 y/o may be affected
What are 5 key History Questions to ask in Mind for CRPS?
1) Recent Trauma?
2) How do you Describe the Pain?
3) Dominant hand/leg or not?
4) Worse pain on one side?
5) Pain anywhere else?
4 Red Flags for CRPS?
Allodynia or Hyperalgesia
Vasomotor abnormalities
Sensation abnormalities
Described as Intense, localized burning
What are 3 tests and measures we should use with CRPS?
1) Skin sensation
2) Circumferential Measurements
3) Dermatome/Myotome Spinal Cord level testing
