DESCRIPTION
SIGNS & SYMPTOMS
DIAGNOSTIC TESTS
PT IMPLICATIONS
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- A multifaceted (complex) pain syndrome, usually (but not always) having an initiating noxious event in the periphery, not limited to a single nerve (regional, nondermatomal), disproportionate to the inciting event, with altered sudomotor and vasomotor function, often causing trophic alterations and loss of function
SIGNS & SYMPTOMS
- Continuing pain that is disproportionate to any inciting event
- Must report pain in one of the following categories:
- Sensory: hyperalgesia, allodynia (i.e., pain in response to nonpainful stimuli such as touch or temperature)
- Vasomotor: temperature asymmetry, skin color changes, skin color asymmetry
- Sudomotor/edema: edema, sweating changes, sweating asymmetry
- Motor/trophic: decreased range of motion (ROM),motor dysfunction (e.g.,weakness, tremor, dystonia), trophic changes)
DIAGNOSTIC TESTS
- There are no definitive diagnostic tests of CRPS, including imaging modalities such as plain x-ray or three-phase scintillography, EMG, thermography, or sympathetic nerve blocks
- The diagnosis of CRPS is largely made through clinical exam and through the process of ruling out other medical conditions
- Doppler ultrasound to rule out blood clots
- X-ray to rule out acute fracture, osteomyelitis, and neoplasm; may show osteopenia
- Triple-phase bone scans can be used to identify changes in the bone and in blood circulation and to rule out other pathologies
PT IMPLICATIONS
- There is no evidence that early physiotherapy can prevent CRPS; however, early diagnosis and therapy are recommended to decrease suffering, improve function, and prevent complications such as contractures.
- Encourage safe, gentle movements (ankle pumps, opening/closing fist) with patients at risk for developing CRPS (trauma or immobilization of an extremity).
- Maintain increased weight-bearing activities through the affected extremity with a home exercise program focused on weight-bearing exercises.
- Focus on early mobilization for susceptible patients.
- Education about pain management techniques (e.g., relaxation techniques) and pacing (e.g.,appropriate rest breaks, alternating tasks) may be helpful.
(click here to see references)