Demography and Treatment of Complex Regional Pain Syndrome Among Children
American Journal of Clinical and Experimental Medicine
Volume 8, Issue 1, January 2020, Pages: 6-9
Received: Mar. 2, 2020;
Accepted: Apr. 8, 2020;
Published: Apr. 29, 2020
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Martin Lehmann Boesen, Hans Christensen Children Hospital, Odense University Hospital, Odense, Denmark
Anne Estmann Christensen, Hans Christensen Children Hospital, Odense University Hospital, Odense, Denmark
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Introduction: Complex Regional Pain syndrome (CRPS) is a rare chronic pain syndrome characterized by amplified pain and autonomic dysfunction. A systematic multidisciplinary treatment program for affected children exists at our department. This study aims to estimate the incidence of CRPS and describe the demography, symptoms and psychosocial characteristics of the patients and evaluate the treatment results. Method: A retrospective medical chart review of all patients under the age of 16 years treated for CRPS between 2004 and 2014 at Hans Christian Andersen Children Hospital. Results: A total of 29 children fulfilled the diagnostic criteria for CRPS. The mean incidence was 2,4/100.000 children per year. Most patients were girls (90%) with a median age of 11 years. A lower extremity was most often involved (86%). Time to diagnosis had a mean of 174 days. All patients reported complete disappearance or significant reduction of pain at discharge without any medication. Walking was normalized in 75% and almost 1/3 could run normally. School attendance and social life was restored. Conclusion: The typical child with CRPS is a girl of normal stature, around 11 years old, who is affected by intolerable pain in a lower extremity and has severe limitation in walking. The condition is rare with a mean incidence of 2,4/100.000 children. Attention is important in order to reduce the diagnostic delay. Our treatment program was successful as the children were in reduced pain, gaining normal physical function and out of social isolation at completion of the program.
Pain, Children, Musculoskeletal Symptoms, Physiotherapy
To cite this article
Martin Lehmann Boesen,
Anne Estmann Christensen,
Demography and Treatment of Complex Regional Pain Syndrome Among Children, American Journal of Clinical and Experimental Medicine.
Vol. 8, No. 1,
2020, pp. 6-9.
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
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Saxton DL, Lindenfeld TN. Complex regional pain syndromes, including reflex sympathetic dystrophy and causalgia. DeLee & Drez’s Orthopaedic Sports Medicine chapter 7, section A, 351-369.
Birklein F. Complex regional pain syndrome. J Neurol 2005; 252: 131–138.
O’Connell NE et al. Interventions for treating pain and disability in adults with complex regional pain syndrome - an overview of systematic reviews. Cochrane Database of Systematic Reviews 2013; Issue 4.
Weissmann R, Uziel Y. Pediatric complex regional pain syndrome: a review. Pediatric Rheumatology 2016; 14: 29.
Borchers AT, Gershwin ME. Complex regional pain syndrome a critical review. Autoimmunity Reviews 2014; 13: 242–265.
Logan et al. Children and adolescents with complex regional pain syndrome: More psychologically distressed than other children in pain? Pain Res Manag 2013 March/April; 18: 87-93.
Merskey H, Bogduk N. Classification of Chronic Pain: Descriptions of Chronic Pain Syndromes and Definitions of Pain Terms 1994; 2nd ed. IASP Press, Seattle.
Wilson P, Stanton-Hicks, Harden RN. CRPS: Current Diagnosis and Therapy. Progress in Pain Research and Management 2005; Vol. 32 IASP Press, Seattle.
Stanton-Hicks. Plasticity of complex regional pain syndrome (CRPS) in children. Pain Med 2010 Aug; 11: 1216-23.
Sherry DD et al. Short- and long-term outcomes of children with complex regional pain syndrome type I treated with exercise therapy. Clinical Journal of Pain 1999; 15: 218-223.
Rodriguez MJ et al. Invasive Management for Pediatric Complex Regional Pain Syndrome: Literature Review of Evidence. Pain Physician 2015 Nov; 18: 621-30.
Lebel A, Becerra L, Wallin D. fMRI reveals distinct CNS processing during symptomatic and recovered complex regional pain syndrome in children. Brain 2008 Jul; 131: 1854-79.
de Rooij AMr, de Mos M, Sturkenboom MC. Familial occurrence of complex regional pain syndrome. Eur J Pain 2009 Feb; 13: 171-7.
Richards S, Chalkiadis G, Lakshman R. Complex regional pain syndrome following immunisation. Arch Dis Child 2012 Oct; 97: 913-5.
Logan DE, Williams SE, Carullo VP. Children and adolescents with complex regional pain syndrome: More psychologically distressed than other children in pain? Pain Res Manag 2013; 18: 87-93.
Mesaroli G et al. Clinical Features of Pediatric Complex Regional Pain Syndrome: A 5-Year Retrospective Chart Review. Clin J Pain. 2019; 35: 933-940.
Cucchiaro G et al. Short- and long-term results of an inpatient programme to manage Complex Regional Pain Syndrome in children and adolescents. Br. J. Pain. 2017 May; 11: 87-96.