Persistence of Post-Traumatic CRPS Associated With Initial Pain Sensitization

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At 12 months after injury, CRPS symptoms improved in 52% of participants who had been diagnosed with CRPS I at 3 months after injury.
At 12 months after injury, CRPS symptoms improved in 52% of participants who had been diagnosed with CRPS I at 3 months after injury.

The level of pain sensitization in the early post-trauma period in patients with complex regional pain syndrome (CRPS) type 1 after distal radius fractures may be associated with the persistence of CRPS symptoms, according to a study published in Pain Medicine.

Patients who had been diagnosed with CRPS I based on the Budapest Criteria within 6 months of a distal radius fracture were included in the study (n=58 and n=58 age- and gender-matched participants with distal radius fracture but no CRPS I, respectively). The researchers measured participants' pressure pain thresholds (PPTs) in the forearm and administered a Pain Sensitivity Questionnaire (PSQ) to participants with a pain score ≥4 on a numeric rating scale at the 3-month follow-up. Participants were evaluated at 3, 6, and 12 months after injury.

Participants with vs without CRPS I were found to be more likely to have sustained high-energy injuries and severe fractures; they also had higher PSQ scores and lower PPTs scores. At 12 months after injury, CRPS symptoms improved in 30 participants (52%) who had been diagnosed with CRPS I at 3 months after injury. In participants with CRPS, the initial degree of pain sensitization and high-energy injury were associated with persistence of CRPS symptoms up to 12 months after initial injury.

“More research is needed to show whether early identification and treatment of pain sensitization, such as pharmacological therapies, cognitive behavioral therapy, or exercise therapy, will improve CRPS I prognosis after distal radius fractures,” the researchers wrote.

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Reference

Rok YH, Gong HS, Baek GH. Prognostic value of pain sensitization during early recovery after distal radius fracture in complex regional pain syndrome. [published online November 8, 2018]. Pain Medicine. doi:10.1093/pm/pny184

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