CRPS Flashcards
what is it
chronic neuropathic pain that follows limb injury
-pain lasts longer and is more severe than expected for the original tissue damage
-diagnosis is clinical
what is it related to
-crush injuries
-distal radius fracture
-tibial fracture
-traumatic peripheral nerve injuries
what is warm CRPS
-warm, dry
-red
-edematous
what is cold CRPS
-cold, blue
-sweaty
-less edematous
20 months
what is type I
without major nerve damage
(pain syndrome triggered by a soft tissue or bone injury not associated with an identifiable nerve injury)
-often a crush injury, particularly in LE
-following immobilization
-may also follow amputation, MI, stroke or cancer
what is type II
with major nerve damage
(pain syndrome similar to type I)
-invovle direct partial or complete injury to peripheral nerve
what is the epidemiology
females>males
UE>LE
mean age 46-52 years
type I>type II
what is hyperesthesia
unusual increased or altered sensitivit to sensory stimuli
what is hyperalgesia
increased sensitivity to pain
what is allodynia
condition in which ordinarily nonpainful stimuli evokes pain
what are the symptoms
continuing pain disproportionate to inciting event AND
symptoms in 3 of 4 categories;
-sensory: hyperesthesia/allodynia
-vasomotor: temp asymm/ skin color changes
-sudomotor/edema: edema/sweating
-motor/trophic: decreased ROM/motor dysfunction/trophic changes
what are the signs
must display at least 1 sign at the time of evaluation in 2 or more categories
-sensory
-vasomotor
-sudomotor/edema
-motor/trophic
what is the pathophysiology of it
-central sensitization
-peripheral sensitization
-release of neuropeptides: substance P and calcitonin
-altered sympathetic nervous system
what is acute CRPS
reduced SNS function
-vasodilation: warm/red
inflamm factors
what is chronic CRPS
increased SNS function
-vasoconstriction
-super sensitive to catecholamines
-trophic changes
