Complex Regional Pain Syndrome (CRPS)

Question 1

CRPS Definition

Answer 1

• Pain disproportionate to an injury that is either:
  1. Sympathetically maintained
  OR
  2. Independent of the sympathetic nervous system (traditionally called “reflex sympathetic dystrophy)
• CRPS is the primary and most severe complication of hand and distal radius fractures

Question 2

Type I CRPS

Answer 2

• Develops after a noxious event

Question 3

Type II CRPS

Answer 3

• Develops after a nerve injury

Question 4

Symptoms of CRPS

Answer 4

1. Allodynia (sensation misinterpreted as pain)
2. Hyperalgesia (increased response to painful stimuli)
3. Hyperpathia (exaggerated, sometimes delayed response to sensory stimuli)
4. Edema
5. Contractures
6. Bluish or red, shiny skin
7. Abnormal sweating and hair growth
8. Muscle spasms
9. Decreased strength
10. Low tolerance for activity

Question 5

OT Interventions for CRPS

Answer 5

1. Gentle, PAIN-FREE AROM for short periods (NO PROM and NO painful treatment)
2. Stress loading (e.g., scrubbing the floor or carrying a weighted handbag) and functional activities that promote weight bearing
3. Pain control techniques (e.g., TENS, splinting)
4. Edema control techniques (e.g., elevation, massage, AROM, contrast baths, compression)
5. Desensitization techniques, fluidotherapy
6. Blocked exercises, tendon gliding
7. Joint protection, energy conservation