scholarly journals Beliefs and Clinical Practice for Complex Regional Pain Syndrome (CRPS) Managed by Physiotherapists on the South Island of New Zealand

2017 ◽  
Vol 08 (01) ◽  
pp. 42-54 ◽  
Author(s):  
Tracey Pons ◽  
Edward A. Shipton ◽  
Roger T. Mulder
Keyword(s):  
Clinical Practice ◽  
New Zealand ◽  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
The South

scholarly journals Physiotherapy Interventions and the Outcomes for Complex Regional Pain Syndrome (CRPS) Type 1 on the South Island of New Zealand – A Longitudinal, Prospective Case Series

2017 ◽  
Vol 10 (1) ◽  
pp. 5-13 ◽  
Author(s):  
Tracey Pons ◽  
Edward Shipton ◽  
Jonathan Williman ◽  
Roger Mulder
Keyword(s):  
New Zealand ◽  
Complex Regional Pain Syndrome ◽  
Case Series ◽  
Pain Syndrome ◽  
Pain Modulation ◽  
Functional Restoration ◽  
World Health ◽  
The South ◽  
Clinical Records ◽  
Prospective Longitudinal

Physiotherapy is considered in pain medicine to be a key element in the management of Complex Regional Pain Syndrome (CRPS). This is the first paper to document and categorise all physiotherapy intervention methods used as well as evaluate the outcomes of a case series of 18 CRPS patients attending physiotherapy in a prospective, longitudinal study across a region. Outcomes were measured across the region of the South Island of New Zealand over 1 year through independent telephonic interviewing of the pain experience with the McGill Pain Questionnaire-short form, function with Foot Function Index for the lower limb or Disability of the Arm Shoulder and Hand for the upper limb, and quality of life with the World Health Organisation Disability Schedule. Clinical records were accessed for each CRPS participant following discharge from physiotherapy to categorise the intervention methods used. Seventeen participants received intervention for both functional restoration with pain modulation and only one participant received functional restoration with no pain modulation; 12 also received immobilisation with 10 receiving passive interventions. All outcome measures improved significantly by 6 months and were maintained at 1 year. Eighty five percent had their diagnosis of CRPS confirmed within 3 months of their injury; half had fracture as the precipitating injury for their onset of CRPS with a third following soft tissue injury and 11% following surgery. Physiotherapists showed a high variation with the intervention methods used and showed a greater proportion of intervention methods focusing on functional restoration followed by pain modulating interventions. Future research is necessary to define what physiotherapy interventions are efficacious in the management of CRPS.

Challenges in the Diagnostic Conceptualization of CRPS-1 (Formerly Conceptualized as RSD)

2006 ◽  
Vol 11 (2) ◽  
pp. 1-3, 9-12
Author(s):  
Robert J. Barth ◽  
Tom W. Bohr
Keyword(s):  
Clinical Practice ◽  
Complex Regional Pain Syndrome ◽  
Somatoform Disorders ◽  
International Association ◽  
Pain Syndrome ◽  
Somatoform Disorder ◽  
Syndrome Type ◽  
Previous Issue

Abstract From the previous issue, this article continues a discussion of the potentially confusing aspects of the diagnostic formulation for complex regional pain syndrome type 1 (CRPS-1) proposed by the International Association for the Study of Pain (IASP), the relevance of these issues for a proposed future protocol, and recommendations for clinical practice. IASP is working to resolve the contradictions in its approach to CRPS-1 diagnosis, but it continues to include the following criterion: “[c]ontinuing pain, which is disproportionate to any inciting event.” This language only perpetuates existing issues with current definitions, specifically the overlap between the IASP criteria for CRPS-1 and somatoform disorders, overlap with the guidelines for malingering, and self-contradiction with respect to the suggestion of injury-relatedness. The authors propose to overcome the last of these by revising the criterion: “[c]omplaints of pain in the absence of any identifiable injury that could credibly account for the complaints.” Similarly, the overlap with somatoform disorders could be reworded: “The possibility of a somatoform disorder has been thoroughly assessed, with the results of that assessment failing to produce any consistencies with a somatoform scenario.” The overlap with malingering could be addressed in this manner: “The possibility of malingering has been thoroughly assessed, with the results of that assessment failing to produce any consistencies with a malingering scenario.” The article concludes with six recommendations, and a sidebar discusses rating impairment for CRPS-1 (with explicit instructions not to use the pain chapter for this purpose).

scholarly journals Complex regional pain syndrome: An international survey of clinical practice

2019 ◽  
Vol 23 (10) ◽  
pp. 1890-1903 ◽  
Author(s):  
Sharon Grieve ◽  
Alison Llewellyn ◽  
Louise Jones ◽  
Sarah Manns ◽  
Victoria Glanville ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
International Survey

scholarly journals Thermography in Neurologic Practice

2015 ◽  
Vol 9 (1) ◽  
pp. 24-27 ◽  
Author(s):  
Eduardo Borba Neves ◽  
José Vilaça-Alves ◽  
Claudio Rosa ◽  
Victor Machado Reis
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Experimental Design ◽  
Complex Regional Pain Syndrome ◽  
Diagnostic Tool ◽  
Pain Syndrome ◽  
Future Research ◽  
Monitoring Tool ◽  
Chronological Period ◽  
Infrared Cameras

One kind of medical images that has been developed in the last decades is thermal images. These images are assessed by infrared cameras and have shown an exponential development in recent years. In this sense, the aim of this study was to describe possibilities of thermography usage in the neurologic practice. It was performed a systematic review in Web of Knowledge (Thompson Reuters), set in all databases which used two combination of keywords as “topic”: “thermography” and “neurology”; and “thermography” and “neurologic”. The chronological period was defined from 2000 to 2014 (the least 15 years). Among the studies included in this review, only seven were with experimental design. It is few to bring thermography as a daily tool in clinical practice. However, these studies have suggested good results. The studies of review and an analyzed patent showed that the authors consider the thermography as a diagnostic tool and they recommend its usage. It can be concluded that thermography is already used as a diagnostic and monitoring tool of patients with neuropathies, particularly in complex regional pain syndrome, and stroke. And yet, this tool has great potential for future research about its application in diagnosis of other diseases of neurological origin.

scholarly journals Using graded motor imagery for complex regional pain syndrome in clinical practice: Failure to improve pain

2011 ◽  
Vol 16 (4) ◽  
pp. 550-561 ◽  
Author(s):  
S. Johnson ◽  
J. Hall ◽  
S. Barnett ◽  
M. Draper ◽  
G. Derbyshire ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Complex Regional Pain Syndrome ◽  
Motor Imagery ◽  
Pain Syndrome ◽  
Graded Motor Imagery

A Historical Review of Complex Regional Pain Syndrome in the “Guides Library”

2009 ◽  
Vol 14 (6) ◽  
pp. 1-9
Author(s):  
Robert J. Barth
Keyword(s):  
Differential Diagnosis ◽  
Complex Regional Pain Syndrome ◽  
Reflex Sympathetic Dystrophy ◽  
International Association ◽  
Historical Review ◽  
Pain Syndrome ◽  
Sixth Edition

Abstract Complex regional pain syndrome (CRPS) is a controversial, ambiguous, unreliable, and unvalidated concept that, for these very reasons, has been justifiably ignored in the “AMA Guides Library” that includes the AMAGuides to the Evaluation of Permanent Impairment (AMA Guides), the AMA Guides Newsletter, and other publications in this suite. But because of the surge of CRPS-related medicolegal claims and the mission of the AMA Guides to assist those who adjudicate such claims, a discussion of CRPS is warranted, especially because of what some believe to be confusing recommendations regarding causation. In 1994, the International Association for the Study of Pain (IASP) introduced a newly invented concept, CRPS, to replace the concepts of reflex sympathetic dystrophy (replaced by CRPS I) and causalgia (replaced by CRPS II). An article in the November/December 1997 issue of The Guides Newsletter introduced CRPS and presciently recommended that evaluators avoid the IASP protocol in favor of extensive differential diagnosis based on objective findings. A series of articles in The Guides Newsletter in 2006 extensively discussed the shortcomings of CRPS. The AMA Guides, Sixth Edition, notes that the inherent lack of injury-relatedness for the nonvalidated concept of CRPS creates a dilemma for impairment evaluators. Focusing on impairment evaluation and not on injury-relatedness would greatly simplify use of the AMA Guides.

Peripheral Nerve and Brachial Plexus Impairment, AMA Guides, Sixth Edition

2017 ◽  
Vol 22 (2) ◽  
pp. 3-5
Author(s):  
James B. Talmage ◽  
Jay Blaisdell
Keyword(s):  
Peripheral Nerve ◽  
Brachial Plexus ◽  
Complex Regional Pain Syndrome ◽  
Lower Extremities ◽  
Pain Syndrome ◽  
Upper Extremities ◽  
Motor Deficits ◽  
Type I ◽  
Sixth Edition ◽  
Nerve Entrapments

Abstract Physicians use a variety of methodologies within the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, to rate nerve injuries depending on the type of injury and location of the nerve. Traumatic injuries that cause impairment to the peripheral or brachial plexus nerves are rated using Section 15.4e, Peripheral Nerve and Brachial Plexus Impairment, for upper extremities and Section 16.4c, Peripheral Nerve Rating Process, for lower extremities. Verifiable nerve lesions that incite the symptoms of complex regional pain syndrome, type II (similar to the former concept of causalgia), also are rated in these sections. Nerve entrapments, which are not isolated traumatic events, are rated using the methodology in Section 15.4f, Entrapment Neuropathy. Type I complex regional pain syndrome is rated using Section 15.5, Complex Regional Pain Syndrome for upper extremities or Section 16.5, Complex Regional Pain Syndrome for lower extremities. The method for grading the sensory and motor deficits is analogous to the method described in previous editions of AMA Guides. Rating the permanent impairment of the peripheral nerves or brachial plexus is similar to the methodology used in the diagnosis-based impairment scheme with the exceptions that the physical examination grade modifier is never used to adjust the default rating and the names of individual nerves or plexus trunks, as opposed to the names of diagnoses, appear in the far left column of the rating grids.

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