Complex Regional Pain Syndrome and Factitious Disorders-Complex Regional Pain Syndrome of the Upper Extremity

Complex Regional Pain Syndrome of the Upper Extremity

Pdf Summary

Complex regional pain syndrome (CRPS) is a challenging condition to diagnose and manage. It is characterized by pain, hypersensitivity, swelling, stiffness, and other symptoms. Early intervention is important in improving outcomes, but some patients may progress despite treatment. Multidisciplinary management is often necessary for complex cases. The onset of signs and symptoms can be obvious or insidious, with a temporal delay being common. Difficulty sleeping, pain unresponsive to narcotics, swelling, stiffness, and hypersensitivity are warning signs of onset. Treatment typically involves a multimodal approach with hand therapy, sympatholytic drugs, stress loading, and anesthesia blocks. Surgery may be considered if dystrophic symptoms are controllable by medications and a nociceptive focus or nerve derangement is correctable. Chronic sequelae like contracture may also be surgically addressed in patients with controllable pain. Postinjury and postoperative outcomes are negatively affected by CRPS, leading to prolonged recovery, complications, impaired rehabilitation, stiffness, inferior functional results, increased time to return to work, increased litigation, and reduced patient satisfaction. It is important to accurately diagnose and manage CRPS to improve patient outcomes and minimize liability. The disease has no single pathognomonic test or marker, but diagnostic criteria include pain syndrome, autonomic dysfunction, trophic changes, and functional impairment. CRPS treatment options include therapy, oral medications, parenteral medications, psychological support, and surgery. There are several myths surrounding CRPS that need to be dispelled, such as the condition being purely psychiatric or the belief that it spreads throughout the body. Overall, recognizing the symptoms of CRPS, providing early intervention, and using a multimodal treatment approach can help improve patient outcomes.

Keywords

Complex regional pain syndrome

diagnosis

management

pain

hypersensitivity

swelling

stiffness

early intervention

multidisciplinary management

treatment