University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository


Pain Management


Thomas Colletti


Background/Intro: CRPS is a chronic disorder that predominantly affects the limbs with motor, sensory, and autonomic dysfunction.2 CRPS is most commonly incited from surgery or trauma to the affected limb. Symptoms can vary from case to case and which can lead to delayed diagnosis and treatment resulting in permanent debilitating consequences.

Epidemiology: CRPS incidence is approximately 20/100,000 , peak incidence is between ages 50-70 years old. 1

Etiology: >44% of CRPS cases results from injury, 185 from ligamentous injury and 12% attributed to surgery.6

Pathophysiology: Genetic predisposition, post traumatic inflammation in acute CRPS. CRPS symptoms vary so widely pathophysiology can differ greatly as well, thus CRPS pathophysiology is attributed to a multifactorial issues that involves both the peripheral and central nervous system

Diagnostic Criteria: Budapest Criteria; How to differentiate between CRPS 1 and CRPS 2

Signs/ Symptoms: Allodynia, skin color/ temperature asymmetry, trophic changes, sweating, motor changes, limited range of motion.3

Treatments: Physical/ Occupational therapy, psychological therapy, corticosteroids, NSAIDs, TCA’s, bisphosphonates, Opiates, spinal cord stimulation, sympathetic nerve blocks, adjunct Vitamin C.3


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