Diagnostic criteria in patients with complex regional pain syndrome assessed in an out-patient clinic

July 10th, 2010

Study conducted at Department of Anesthesiology, Pain Treatment Centre.

Published: 23 April 2010

ABSTRACT – Full document at Wiley InterScience

Methods: We included 195 patients who were referred to our pain clinic within a period of 1 year. Data were collected on patient characteristics, signs, symptoms, disease-related medication, and the background of the referring clinicians.

Results: The Harden and Bruehl criteria were confirmed in 95 patients (49%). These patients used a higher than average number of analgesics, opiates, and anti-oxidants, and frequently received prescriptions for benzodiazepines instead of anti-depressants. The mean disease duration was 29 ± 4.6 months and the mean visual analogue score for pain was 8.1 ± 0.19. A subgroup of patients had a colder temperature in the affected extremity compared with the unaffected extremity. This subgroup showed a longer disease duration and higher visual analogue scale pain.

Conclusion: The diagnostic criteria used to determine CRPS should be further improved. A large number of referred patients experienced substantial pain, without receiving adequate medication. Disease-related medication is unrelated to CRPS-specific disease activity. Knowledge of underlying mechanisms is warranted before an adequate pharmaceutical intervention can be considered.

E. A. M. VAN BODEGRAVEN HOF 1 , G. J. GROENEWEG 1 , F. WESSELDIJK 1 , F. J. P. M. HUYGEN 1 and F. J. ZIJLSTRA 11 Department of Anesthesiology, Pain Treatment Centre, Erasmus MC, Rotterdam, the Netherlands

Correspondence to Address: J. George Groeneweg, Department of Anesthesiology Pain Treatment Centre Erasmus MCPO Box 20403000 CA Rotterdam The Netherlands | e-mail: j.groeneweg(at)erasmusmc.nl
Accepted for publication 23 April 2010
DIGITAL OBJECT IDENTIFIER (DOI)10.1111/j.1399-6576.2010.02251.x About DOI