Novel Signs and Their Clinical Utility in Diagnosing Complex Regional Pain Syndrome (CRPS): A Prospective Observational Cohort Study

The objectives of our study were to define and validate 4 bedside tests, to identify the prevalence of positive tests in patients with CRPS and other chronic pain conditions, and to assess the clinical utility (sensitivity, specificity, positive predictive value, negative predictive value) for identifying CRPS within a Fracture cohort. This was a single UK teaching hospital prospective cohort study with 313 recruits from pain-free volunteers and patients with chronic pain conditions. Four novel tests were Finger Perception (FP), Hand Laterality identification (HL), Astereognosis (AS), and Body Scheme (BS) report. Five questionnaires (Brief Pain Inventory, Upper Extremity Functional Index, Lower Extremity Functional Index, Neglect-like Symptom Questionnaire, Hospital Anxiety and Depression Score) assessed the multidimensional pain experience. Results: FP and BS were the best performing tests. Prospective monitoring of fracture patients showed that out of 7 fracture patients (total n=47) who had both finger misperception and abnormal BS report at initial testing, 3 developed persistent pain with 1 having a formal diagnosis of CRPS. Discussion: Novel signs are reliable, easy to perform, and present in chronic pain patients. FP and BS have significant clinical utility in predicting persistent pain in a fracture group thereby allowing targeted early intervention.
Source: The Clinical Journal of Pain - Category: Anesthesiology Tags: Original Articles Source Type: research

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Complex regional pain syndrome (CRPS) and fibromyalgia are chronic pain conditions of unexplained origins. In addition to symptoms in the diagnostic criteria, patients can report changes to vision and other sensations or bodily functions. It is unclear whether these are greater than would be expected due to normal ageing, living with chronic pain generally, or common comorbidities of chronic pain such as depression or anxiety. We administered an on-line survey evaluating the frequencies and types of self-reported somatic symptoms, bodily changes, and sensory sensitivity in respondents with CRPS (n = 390), fibromyalgia (n =...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
Hui Xu1,2,3, Chenguang Guo1, Haining Li1, Lin Gao2, Ming Zhang1* and Yuan Wang1* 1Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China 2Key Laboratory of Biomedical Information Engineering of Education Ministry, Institute of Biomedical Engineering, Xi'an Jiaotong University, Xi'an, China 3Faculty of Dentistry, University of Toronto, Toronto, ON, Canada Background and Purpose: Hemifacial spasm (HFS) is a rare neuromuscular disorder characterized by unilateral, involuntary, and paroxysmal contractions of orofacial muscles. To eluci...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Conclusions: Currently available immersive virtual reality technology with myolectric and motion tracking control may represent a possible therapy option for treatment-resistant phantom limb pain. Keywords: virtual reality, phantom limb pain, rehabilitation, amputation, therapy, pain Innov Clin Neurosci. 2017;14(7–8):3–7 Phantom limb pain (PLP), the sensation of pain in an absent limb, is a frequent complication after amputation, with reported prevalence rates ranging from 40 to 85 percent.1,2 While the exact mechanism of PLP remains to be elucidated, peripheral and central neural factors are thought to contrib...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Case Report Current Issue amputation pain phantom limb pain rehabilitation therapy virtual reality Source Type: research
“I have chosen a surreal art approach to represent my invisible disability, due to the surreal nature of mental illness,” tattoo artist Lindsay Carter expressed in a statement. Carter’s image ― featured on the right, above ― shows a bird whose head is a cage with a giant eyeball protruding from the dreamlike vision.  “As long as I’ve been consciously aware, I’ve been diagnosed with generalized anxiety disorder and major depressive disorder,” she continued. “Severe episodes can happen for no apparent reason and at that point I cannot help nor snap out of the...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
Publication date: Available online 15 July 2016 Source:Joint Bone Spine Author(s): Pascale Vergne-Salle Chronic postsurgical pain (CPSP) affects 10 to 30% of surgical patients overall and 16 to 20% of patients after knee surgery. Patients report persistent pain in the absence of infection, mechanical disorders, or complex regional pain syndrome type I. In many cases, the mechanism is neuropathic pain related to an intraoperative nerve injury or impaired pain modulation with central sensitization. The clinical risk factors and pathophysiology of CPSP are being actively investigated. Risk factors include preoperative pain; ...
Source: Joint Bone Spine - Category: Orthopaedics Source Type: research
BackgroundNeuropathic pain affects various dimensions of patient health including physical, psychological, and socioeconomic. The spectrum of psychological dysfunction that accompanies this pain phenotype is unknown, as well as differences based on the etiology of the pain among patients referred for spinal cord stimulation (SCS). MethodsWe prospectively assessed SCS referral patients with neuropathic pain for features of psychological distress, either mood or anxiety. Demographic data included age, gender, diagnosis, marital status, and educational level. Screening tools were applied for neuropathic pain (Douleur Neuropat...
Source: Neuromodulation: Technology at the Neural Interface - Category: Biotechnology Authors: Tags: Clinical Research Source Type: research
Abstract BackgroundComplex regional pain syndrome (CRPS) is difficult to effectively treat with unimodal approaches. ObjectiveTo investigate whether CRPS can be effectively treated in a comprehensive interdisciplinary pain management program. DesignObservational cohort study of 49 patients aged 18–89 who fulfilled ‘Budapest Criteria’ for CRPS and completed an interdisciplinary pain management program. Preprogram to postprogram changes in physical functioning, perceived disability, emotional functioning, acceptance, coping, and pain were assessed. The measures used included: Pain Disability Index, Six minu...
Source: Pain Medicine - Category: Anesthesiology Authors: Tags: Original Source Type: research
Abstract BackgroundComplex regional pain syndrome (CRPS) is difficult to effectively treat with unimodal approaches. ObjectiveTo investigate whether CRPS can be effectively treated in a comprehensive interdisciplinary pain management program. DesignObservational cohort study of 49 patients aged 18–89 who fulfilled ‘Budapest Criteria’ for CRPS and completed an interdisciplinary pain management program. Preprogram to postprogram changes in physical functioning, perceived disability, emotional functioning, acceptance, coping, and pain were assessed. The measures used included: Pain Disability Index, Six minu...
Source: Pain Medicine - Category: Anesthesiology Authors: Tags: NEUROPATHIC PAIN SECTION Source Type: research
Complex regional pain syndrome (CRPS) is a chronic pain condition characterized by extremely severe pain, swelling, and changes in the skin, and causes psychological sequelae such as depression, anxiety, and deteriorated quality of life. CRPS patients’ risk for suicide has been reported to be considerably higher than that not only of general populations but also of other chronic pain populations. Considering that conceiving, planning, and committing suicide is closely related to the decline of executive function that regulates cognitive flexibility, planning and organizing, and response inhibition ability, this preli...
Source: The Journal of Pain - Category: Materials Science Authors: Source Type: research
This study investigated whether CRPS can be effectively treated in a comprehensive interdisciplinary pain management program. This is a retrospective chart review of 49 patients (67% female) aged 18-89 (M=39.57) years who fulfilled CRPS Budapest Criteria and completed a 4-week interdisciplinary pain management program between 2008 and 2013. Changes in physical functioning, perceived disability, emotional functioning, coping, and pain were assessed between initial visit and program completion using the following measures: Pain Disability Index (PDI), Six minute walk test (6MWT), two minute sit-to-stand (2MSTS), Numerical Ra...
Source: The Journal of Pain - Category: Materials Science Authors: Source Type: research
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