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561 > Complex regional pain syndrome and carpal tunnel syndrome > Flashcards

Complex regional pain syndrome and carpal tunnel syndrome Flashcards

1
Q

What is a key characteristic of CRPS

A

Pain is out of proportion to the severity of the injury

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2
Q

Who is CRPS more common in

A

Women

ages 40-60

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3
Q

What is CRPS believed to be caused by

A

damage to the peripheral and central nervous system

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4
Q

Where can you have CRPS

A

in arm or leg

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5
Q

What is Type I of CRPS

A

Non specific (no identifiable nerve injury)

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6
Q

What does type I result from

A

after injury or illness (e.g. CVA, TBI, wrist fx, heart attack, infection)

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7
Q

What does Type II develop from

A

after a nerve injury

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8
Q

What is the key symptom of CRPS

A

pain that is intense and burning, gets worse rather than better and pain which spreads to an entire limb or on the opposite side of the body

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9
Q

How long is stage 1 of CRPS

A

2-3 mo

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10
Q

What happens in CRPS stage 1

A 
Changes in skin temp
faster growth of hair and nails
muscle spasms and jt pain
severe burning, aching pain
skin changes(blotchy, thin, shiny, swollen, sweaty)
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11
Q

When is stage 2 of CRPS

A

3-6 mo

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12
Q

What happens in stage 2 CRPS

A

Continued skin changes
nails crack and break more easily
pain becomes worse
stiff jts and weak muscles

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13
Q

What happens in stage 3 CRPS

A

Irreversible changes can be seen
contracted limbs b/c of tightened muscles and tendons
muscle wasting
pain in the entire limb

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14
Q

How to diagnose CRPS

A 
Must have 3 of the following:
Pain and tenderness
increased or decreased blood flow
edema w/ stiffness
skin changes
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15
Q

What is themography

A

measures skin temp and blood flow of you affected and unaffected limb

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16
Q

What is allodynia

A

pain from nonpainful stimuli

17
Q

what is hyperalgesia

A

heightened sensitivity to pain

18
Q

what is hyperalthesia

A

excessive sensitivity esp to the skin

19
Q

What is significant impact or CRPS, why?

A

Psychosocial

decreased socialization, can’t complete ADL’S

20
Q

What can OT do

A 
Adapt things
teach compensation
one handed methods
energy conservation
adaptive devices
jt protection
21
Q

What are types of tx for CRPS

A

Meds-nsaids, anti depressants
pain management- tens, biofeedback
anesthetic blocks
Ot

22
Q

What are modalities and treatments to avoid in OT for CRPS

A 
PROM
Jt. Mobilization
dynamic splinting 
casting 
(would be painful)
23
Q

What is another ot tx

A

stress loading

24
Q

What does stress loading do

A

stimulates large fiber receptors

25
Q

What do you do w/ stress loading

A

scrubbing/carrying activities

brush held in affected hand

26
Q

What is the goal of stress loading

A

to bear as much weight as possible through the affected arm

27
Q

What are the results of stress loading

A

pain and swelling increase for 1st few days

90% returned to work, lower swelling and pain w/in 1st wks of tx

28
Q

Modifications for stress loading

A

can be done from w/c at low table
If U/E limited, can provide active assist w/ towel
use handled brush (allows wrist to be in neutral)

29
Q

How long are stress loading session

A

3min/session 3 session/day

increase to 10-15 min

30
Q

What is the 2nd part of stress loading

A

carry activities

31
Q

What do you do w/ carrying activities

A

start w/ small objects carried in hand progressing to handled bag loaded w/ increasingly heavier weight.
avg. 8-10 lbs

32
Q

What is carpal tunnel syndrome (CTS)

A

Compression of median nerve

33
Q

what are risk factors for cts

A

female, repetitive wrist use, oral contraceptives, pregnancy, prior surgical removal of ovaries, hypothyroidism, diabetes, RA, prior wrist fx

34
Q

What is the etiology of CTS

A

idiopathic: can result from repetitive motion or acute trauma

35
Q

What does CTS do

A

impairs sensory transmission to thumb, index finger, and middle finger. if chronic, motor function can be affected
many cases, pain receptors are also stimulated

36
Q

Tests for CTS

A

Phalens
Reverse phalens
Tinel

37
Q

What is conservative tx for CTS

A

Splinting: wrist in 0-15 deg ext
tendon gliding exercises
modalities: contrast baths, phonophoresis, topically applied drugs
pt. edu: env. mod, ergonomics, jt/ protection, posture

38
Q

CTS surgical tx

A

sx to release transverse carpal lig. to decrease entrapment and pressure

39
Q

What does CRPS usually result from

A

follows a noxious event from small injury (paper cut) to large (fracture)

561 (11 decks)

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