NPTE: Complex Regional Pain Syndrome

Type 1 vs type 2

Clinical features of CRPS

▪ Symptoms more marked distally in an extremity

▪ Symptoms progress in intensity and spread proximally

▪ Disproportion of symptoms in relation to the causing event

▪ A specific diagnosis, such as diabetes, or fibromyalgia, has been excluded

Signs and symptoms

▪ Pain is the key features

▪ Sensory abnormalities (burning pain and allodynia)

▪ Trophic changes

▪ Impairments of motor function

▪ Emotional/psychological responses

Common impairments of structure in CRPS

▪ Pain or hyperesthesia in extremity disproportionate to any inciting event

▪ Limitation of motion and/or motor dysfunction (weakness, tremor, dystonia)

▪ Sudomotor/edema: edema and/or sweating changes and/or sweating asymmetry (hyper or hypohydrosis)

▪ Vasomotor instability: temperature asymmetry and/or skin color changes and/or asymmetry

▪ Trophic changes: increased or decreased hair and nail growth and/or skin changes (thin or shiny)

Common impairments of function, activity limitations, and participation restrictions

▪ Pain avoidance behaviors, resulting in decreased use of the involved limb in ADLs, which may cause muscle

atrophy or osteoporosis/osteopenia in chronic stages

▪ Slower at initiating movement and/or slower and more inaccurate in executing targeted movement with the

involved limb

▪ Gait abnormalities

▪ Limitations in ability to participate in gainful employment and/or housework and in leisure activities

Early intervention

Chronic stage intervention