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.

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“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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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