Literature DB >> 26361462

Outcomes of a Simple Treatment for Complex Regional Pain Syndrome Type I in Children.

Frederick R Dietz1, Stephen P Compton1.   

Abstract

BACKGROUND: Chronic Regional Pain Syndrome type I (CRPSI) in children is a disorder of unknown etiology. No standard diagnostic criteria or treatment exists. Published treatment protocols are often time and resource intensive. Nonetheless, CRPSI is not rare and can be disabling. This reports the results of a simple and inexpensive treatment protocol involving no medicines, nerve blockades, physical therapy resources or referrals to pain specialists. The patient is instructed in a self-administered massage and mobilization program. The diagnosis required allodynia (pain on light touch of the skin) and signs or the history of signs of autonomic dysfunction.
METHODS: A chart review of patient coded for "reflex sympathetic dystrophy" or 'autonomic dysfunction" was performed yielding a cohort of eighty-three patients treated by a common protocol. Most patients were identified in the last 15 years. Most patients with this CRPSI were doubtless coded simply as "foot pain" or "knee pain", etc and were not identified in this search. Charts were reviewed for patient demographics and outcomes. A subset of patients filled out the Pediatric Outcomes Data Collection Instrument (PODCI) giving a validated pre-treatment disability measure.
RESULTS: The cohort characteristics were similar to prior reports with respect to age, gender, location, and history of trauma. Of the 26 patients who completed the PODCI before treatment the Pain/Comfort Core Scale score mean was 20.81(0-63). The Global Functioning Scale score mean was 52.11(27-83.5). Eighty-nine percent of 51 patients who attended clinic until their outcome was definite had no or minimal residual pain. Treatment averaged 2.2 visits per patient, typically over a six-week period.
CONCLUSIONS: A simple, inexpensive protocol can be effective in treating CRPSI in children. The protocol is risk free, inexpensive to families and conservative of physician and physical therapy resources. LEVEL OF EVIDENCE: Therapeutic Level IV.

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Year:  2015        PMID: 26361462      PMCID: PMC4492150     

Source DB:  PubMed          Journal:  Iowa Orthop J        ISSN: 1541-5457


  20 in total

1.  Reflex sympathetic dystrophy in children.

Authors:  F R Dietz; K D Mathews; W J Montgomery
Journal:  Clin Orthop Relat Res       Date:  1990-09       Impact factor: 4.176

2.  Reflex sympathetic dystrophy in children: review of a clinical series and description of the particularities in children.

Authors:  O Barbier; N Allington; J J Rombouts
Journal:  Acta Orthop Belg       Date:  1999-03       Impact factor: 0.500

Review 3.  Management of pediatric patients with complex regional pain syndrome.

Authors:  Robert T Wilder
Journal:  Clin J Pain       Date:  2006-06       Impact factor: 3.442

4.  Reflex sympathetic dystrophy in children.

Authors:  R Cimaz; M Matucci-Cerinic; F Zulian; F Falcini
Journal:  J Child Neurol       Date:  1999-06       Impact factor: 1.987

5.  Short- and long-term outcomes of children with complex regional pain syndrome type I treated with exercise therapy.

Authors:  D D Sherry; C A Wallace; C Kelley; M Kidder; L Sapp
Journal:  Clin J Pain       Date:  1999-09       Impact factor: 3.442

6.  Complex regional pain syndromes in children and adolescents.

Authors:  Ludmyla Kachko; Rachel Efrat; Shiri Ben Ami; Masha Mukamel; Jacob Katz
Journal:  Pediatr Int       Date:  2008-08       Impact factor: 1.524

7.  Reflex sympathetic dystrophy in children.

Authors:  S B Ruggeri; B H Athreya; R Doughty; J R Gregg; M M Das
Journal:  Clin Orthop Relat Res       Date:  1982-03       Impact factor: 4.176

Review 8.  Complex Regional Pain Syndromes: guidelines for therapy.

Authors:  M Stanton-Hicks; R Baron; R Boas; T Gordh; N Harden; N Hendler; M Koltzenburg; P Raj; R Wilder
Journal:  Clin J Pain       Date:  1998-06       Impact factor: 3.442

9.  Proposed new diagnostic criteria for complex regional pain syndrome.

Authors:  R Norman Harden; Stephen Bruehl; Michael Stanton-Hicks; Peter R Wilson
Journal:  Pain Med       Date:  2007 May-Jun       Impact factor: 3.750

10.  Pediatric complex regional pain syndrome.

Authors:  Adrian K Low; Kate Ward; Andrew P Wines
Journal:  J Pediatr Orthop       Date:  2007 Jul-Aug       Impact factor: 2.324

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  5 in total

1.  Reduction of Pain Sensitivity after Somatosensory Therapy in Children with Autism Spectrum Disorders.

Authors:  Inmaculada Riquelme; Samar M Hatem; Pedro Montoya
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2.  Recovery from acute pediatric complex regional pain syndrome type I after ankle sprain by early pharmacological and physical therapies in primary care: a case report.

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3.  Canadian surveillance study of complex regional pain syndrome in children.

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Review 4.  The Current View on the Paradox of Pain in Autism Spectrum Disorders.

Authors:  Olena V Bogdanova; Volodymyr B Bogdanov; Adrien Pizano; Manuel Bouvard; Jean-Rene Cazalets; Nicholas Mellen; Anouck Amestoy
Journal:  Front Psychiatry       Date:  2022-07-22       Impact factor: 5.435

Review 5.  Pediatric complex regional pain syndrome: a review.

Authors:  Rotem Weissmann; Yosef Uziel
Journal:  Pediatr Rheumatol Online J       Date:  2016-04-29       Impact factor: 3.054

  5 in total

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