Sensory disturbances induced by sensorimotor conflicts are higher in complex regional pain syndrome and fibromyalgia compared to arthritis and healthy people, and positively relate to pain intensity

2018 ◽  
Vol 23 (3) ◽  
pp. 483-494 ◽  
Author(s):  
Clémentine Brun ◽  
Catherine Mercier ◽  
Sharon Grieve ◽  
Shea Palmer ◽  
Jacqueline Bailey ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Healthy People ◽  
Sensory Disturbances

Factors associated with disability and pain intensity in patients with complex regional pain syndrome

2021 ◽  
pp. 1-9
Author(s):  
Maryam Farzad ◽  
Joy C. MacDermid ◽  
Tara Packham ◽  
Behzad Khodabandeh ◽  
Mohsen Vahedi ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Factors Associated

Are Illness Perceptions Associated with Pain and Disability in Complex Regional Pain Syndrome? A Cross-Sectional Study

Pain Medicine ◽  
2020 ◽  
Author(s):  
Dana R Antunovich ◽  
Juliette C Horne ◽  
Natalie L Tuck ◽  
Debbie J Bean
Keyword(s):  
Pain Intensity ◽  
Complex Regional Pain Syndrome ◽  
Psychological Factors ◽  
Illness Perceptions ◽  
Pain Syndrome ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pain Disability ◽  
Regulation Model

Abstract Objective Complex regional pain syndrome (CRPS) is a complex and often poorly understood condition, and people with CRPS will have diverse beliefs about their symptoms. According to the self-regulation model, these beliefs (termed “illness perceptions”) influence health behaviors and outcomes. Previous studies have found that psychological factors influence CRPS outcomes, but few studies have investigated CRPS patients’ illness perceptions specifically. The present study examined whether illness perceptions were related to pain intensity and other relevant outcomes in people with CRPS. Methods In this cross-sectional study, 53 patients with CRPS (type 1 and type 2) completed questionnaires assessing illness perceptions, pain, disability, and psychological factors. Multiple regression analyses were used to determine whether illness perceptions were associated with pain intensity, disability, depression, and kinesiophobia, after controlling for possible covariates (including clinical and demographic factors, pain catastrophizing, and negative affect). Results Negative illness perceptions were associated with greater pain, disability, and kinesiophobia, but not depression. Specifically, attributing more symptoms to CRPS (more negative illness identity perceptions) was associated with greater pain intensity, and reporting a poorer understanding of CRPS (lower illness coherence scores) was associated with greater disability and kinesiophobia. Conclusions Patients with CRPS with more negative illness perceptions (particularly perceptions indicating a poor understanding of their condition) also experience greater pain, disability, and kinesiophobia. Future research could investigate whether altering CRPS patients’ illness perceptions influences clinical outcomes.

Mycophenolate for persistent complex regional pain syndrome, a parallel, open, randomised, proof of concept trial

2018 ◽  
Vol 18 (1) ◽  
pp. 29-37 ◽  
Author(s):  
Andreas Goebel ◽  
Anu Jacob ◽  
Bernhard Frank ◽  
Paul Sacco ◽  
Guillermo Alexander ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Intensity ◽  
Complex Regional Pain Syndrome ◽  
Rating Scales ◽  
Rating Scale ◽  
Pain Syndrome ◽  
Analysis Of Covariance ◽  
Proof Of Concept ◽  
Numeric Rating

Abstract Background and aims: Current therapies for persistent complex regional pain syndrome (CRPS) are grossly inadequate. With accruing evidence to support an underlying immunological process and anecdotal evidence suggesting potential efficacy of mycophenolate, we wished to explore the feasibility and effectiveness of this treatment in patients with CRPS. Methods: A randomised, open, parallel, proof of concept trial was conducted. Patients with Budapest research criteria CRPS of >2-year duration and moderate or high pain intensity (numeric rating scale score ≥5) were enrolled. Eligible patients were randomised 1:1 to openly receive mycophenolate as add-on treatment, or their usual treatment alone, over 5.5 months. They then switched to the other treatment arm for 5.5 months. The main outcome was average the patients’ average pain intensity recorded over 14 days, between 5.0 and 5.5 months post randomisation, on 11-point (0–10) numeric rating scales, compared between trial arms. Skin sensitivities and additional outcomes were also assessed. Results: Twelve patients were enrolled. Nine provided outcomes and were analysed for the main outcome. Mycophenolate treatment was significantly more effective than control [drug-group mean (SD): pre: 7.4 (1.2)- post: 5.2 (1.3), n=4, control: pre: 7.7 (1.4)- post: 8.1 (0.9), n=5; −2.8 (95% CI: −4.7, −1.0), p=0.01, analysis of covariance]. There were four treatment responders (to mycophenolate treatment either before, or after switch), whose initial exquisite skin hyper-sensitivities, function and quality of life strongly improved. Side effects including itchiness, skin-cryptitis, increased pain, and increased depression caused 45% of the subjects to stop taking mycophenolate. Conclusions: Mycophenolate appears to reduce pain intensity and improve quality of life in a subgroup of patients with persistent CRPS. Implications: These results support the feasibility of conducting a definite trial to confirm the efficacy and effect size of mycophenolate treatment for persistent CRPS (EudraCT 2015-000263-14).

Investigate the Effect of Psychological Factors in Development of Complex Regional Pain Syndrome Type I in Patients with Fracture of the Distal Radius: A Prospective Study

2018 ◽  
Vol 23 (04) ◽  
pp. 554-561 ◽  
Author(s):  
Maryam Farzad ◽  
Fereydoun Layeghi ◽  
Ali Hosseini ◽  
Al Dianat ◽  
Nadiyeh Ahrari ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Distal Radius Fracture ◽  
Complex Regional Pain Syndrome ◽  
Distal Radius ◽  
Psychological Factors ◽  
Pain Syndrome ◽  
Base Line ◽  
Type I ◽  
Syndrome Type ◽  
One Year

Background: To investigate the role of psychological factors (anxiety and depression) and pain measured on a visual analogue scale (VAS) in the development of complex regional pain syndrome type I (CRPS I) following the distal radius fracture (DRF). Methods: A consecutive sample of patients (N=60) with a distal radius fracture was measured for signs of CRPS by Budapest criteria weekly till 8 weeks and then another follow-up one year after injury to determine the incidence and predictors of developing CRPS I in a prospective cohort study and also to discover whether there is difference between pain, depression, and anxiety level in the patients with and without CRPS I. The most of the patients were treated by Pin stabilization. The Beck depression inventoryshort form (BDI), State-Trait Anxiety Inventory, and Numerical pain rating scale were used to determine the patients’ psychological features and pain intensity at the base line and 8 weeks after the fracture. Results: CRPS I developed in 15 (25%) patients after eight weeks and just last in 10 (16.67%) patients after one year. No difference was found between the two groups (CRPS and non-CRPS group) in terms of state (STAI-I) and trait (STAI-II) anxiety, and BDI score. Pain at the base line was the most important risk factor in developing CRPS (odds ratio [OR] =1.52; 95% CI). Conclusions: After fracturing the distal radius, patients who have high pain intensity have a higher risk of developing CRPS I. To following these patients closely for the development of CRPS I may be advantageous for early preventative and therapeutic interventions.

scholarly journals Complex Regional Pain Syndrome: Thalamic GMV Atrophy and Associations of Lower GMV With Clinical and Sensorimotor Performance Data

2021 ◽  
Vol 12 ◽  
Author(s):  
Martin Domin ◽  
Sebastian Strauss ◽  
James H. McAuley ◽  
Martin Lotze
Keyword(s):  
Pain Intensity ◽  
Complex Regional Pain Syndrome ◽  
Gray Matter ◽  
Gray Matter Volume ◽  
Region Of Interest ◽  
Pain Syndrome ◽  
Structural Mri ◽  
Patient Groups ◽  
Posterior Insula ◽  
Sensorimotor Performance

Results on gray matter alterations in complex regional pain syndrome (CRPS) showed heterogeneous findings. Since CRPS is a rare disease, most studies included only small and heterogeneous samples resulting in a low reliability of findings between studies. We investigated 24 CRPS patients with right upper limb affection in the chronic stage of disease using structural MRI and clinical testing. We focused on gray matter volume (GMV) alterations of the brain in comparison to 33 age matched healthy controls, their association to clinical characteristics (duration of pain syndrome and pain intensity ratings) and sensorimotor performance (finger dexterity and spatiotactile resolution). When applying an explorative whole brain analysis CRPS patients showed lower GMV in the bilateral medial thalamus. No other areas showed a relevant GMV difference for the group comparisons. When applying a region of interest driven approach using anatomical masks of the thalamus, ACC/mPFC, putamen, and insula we found relevant associations of clinical and behavioral data in ACC and insula. Whereas, the GMV in ACC showed negative associations with pain intensity and CRPS duration, the GMV of the left posterior insula was negatively associated with sensorimotor performance of the affected hand side. Overall, our results are in accordance to results of others describing a thalamic reduction of GMV in patients with neuropathic pain and are also in accordance with associations of pain intensity and duration with reduced ACC in general in patients with chronic pain syndromes. Sensorimotor performance seems to be related to posterior insula GMV reduction, which has not been described yet for other patient groups.

Hemi-sensory disturbances in patients with complex regional pain syndrome

Pain ◽  
2018 ◽  
pp. 1 ◽  
Author(s):  
Peter D. Drummond ◽  
Philip M. Finch ◽  
Frank Birklein ◽  
Michael Stanton-Hicks ◽  
Lone F. Knudsen
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Sensory Disturbances

Complex Regional Pain Syndrome for Ambulatory Surgery

2018 ◽  
Author(s):  
Caro Monico
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Interdisciplinary Approach ◽  
Rare Condition ◽  
Pain Syndrome ◽  
Signs And Symptoms ◽  
Team Members ◽  
Sensory Disturbances ◽  
Post Traumatic ◽  
And Function

Complex regional pain syndrome (CRPS) is a disease of the nervous system characterized by pain localized in an extremity. This pain is typically out of proportion to the inciting event and is accompanied by sensory disturbances, as well as motor, vasomotor, and sudomotor signs and symptoms. CRPS is a challenging clinical presentation and diagnosis. The etiology of this previously rare condition in children, is typically post-traumatic. It’s management requires a biopsychosocial approach. The principal modality that will improve pain and function in children with CRPS is physical therapy together with an interdisciplinary approach to management. The key to successful treatment involves early appropriate intervention, education for the child and family, and excellent communication between team members. This chapter uses a case study of a 12-year-old girl with CRPS to illustrate these concepts.

PAIN SYNDROMES AFTER MISSILE-CAUSED PERIPHERAL NERVE LESIONS

Neurosurgery ◽  
2006 ◽  
Vol 59 (6) ◽  
pp. 1226-1237 ◽  
Author(s):  
Zoran Roganovic ◽  
Gordana Mandic-Gajic
Keyword(s):  
Pain Intensity ◽  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Diagnostic Procedures ◽  
Syndrome Type ◽  
Type Ii ◽  
Sympathetic Block ◽  
Pain Syndromes ◽  
Neuralgic Pain ◽  
Symptoms And Signs

Abstract OBJECTIVE To report on the clinical characteristics of pain and factors influencing pain intensity in patients with missile-caused nerve injuries. METHODS The prospective study included 326 patients with clinically significant pain syndromes including complex regional pain syndrome Type II, deafferentation pain, reinnervation pain, and neuralgic pain. Diagnostic procedures were analyzed, factors influencing the pain intensity were identified, and the patients' characteristics, pain characteristics, and other clinical symptoms and signs were compared between different types of pain syndromes. RESULTS The rate of painful injuries ranged from 17.3 to 22.9% for mixed nerves and from 2.6 to 4.6% for motor nerves. Peripheral nerve block and sympathetic block were useful and safe adjuvant diagnostic procedures, obtaining pain relief in 66.7% of patients with neuralgic pain and in 90.1% of patients with complex regional pain syndrome Type II. Pain started 2.6 days after injury in patients with complex regional pain syndrome Type II and 11.9 days after injury in patients with painful nerve adhesions (analysis of variance, P< 0.001). Permanent pain was more frequent (79.1%) than paroxysmal pain, superficial pain was more frequent (55.2%) than deep pain, and burning pain was the most frequent pain descriptor (43.6%). Ten factors were found to significantly influence the pain intensity (binary logistic analysis), including three independent predictors (multivariate analysis): type of pain syndrome (P< 0.001), multiple nerve damage in the injury site (P= 0.022), and onset of pain in the first two days after injury (P= 0.031). CONCLUSION Pain syndromes after missile-caused nerve injury differ significantly regarding time of pain onset, pain characteristics, and other symptoms and signs. The type of pain syndrome, multiple nerve damage, and early onset of pain are independent predictors of initial pain intensity. Although medical history and physical examination are the main diagnostic keys, nerve exploration preceded by a nerve block and sympathetic block are safe and useful adjuvant diagnostic procedures.

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