http://www.rsds.org/3/pdf/Modified%2...ster-RSDSA.pdf
INTRODUCTION
Complex regional pain syndromes
(CRPS), formerly referred to as reflex
sympathetic dystrophy and causalgia, are
neuropathic pain states that continue to be
therapeutic challenges.1 Although these
syndromes were described decades ago,
their epidemiology has not been well
studied.
The incidence, prevalence and natural
history of this syndrome as well as the
profile of patients suffering from the disease
is uncertain. Knowledge of the demographic
distribution, e.g., age, gender, race, and
occupation, is based on small sample
sizes.2,3 Moreover, the clinical approach to
a patient suspected to have CRPS is
complicated by a lack of precision of
diagnostic criteria and minimal evidencebased
information on treatment options.
INTRODUCTION
Complex regional pain syndromes
(CRPS), formerly referred to as reflex
sympathetic dystrophy and causalgia, are
neuropathic pain states that continue to be
therapeutic challenges.1 Although these
syndromes were described decades ago,
their epidemiology has not been well
studied.
The incidence, prevalence and natural
history of this syndrome as well as the
profile of patients suffering from the disease
is uncertain. Knowledge of the demographic
distribution, e.g., age, gender, race, and
occupation, is based on small sample
sizes.2,3 Moreover, the clinical approach to
a patient suspected to have CRPS is
complicated by a lack of precision of
diagnostic criteria and minimal evidencebased
information on treatment options.
METHODS
Subjects diagnosed to have CRPS by
their treating physicians provided
information through a questionnaire posted
at the Reflex Sympathetic Dystrophy
Syndrome Association of America (RSDSA)
website. CRPS patients were invited to
participate in the survey, hosted for 6
months from October 2004 to February
2005 (
www.rsdsa.org).
Reminders were sent through e-mail to
members of RSDSA encouraging
individuals to participate in the study.
The 75-question survey was guided by
gaps in the epidemiology of CRPS and a list
of e-queries to the RSDSA website during 2
prior years.
METHODS
Subjects diagnosed to have CRPS by
their treating physicians provided
information through a questionnaire posted
at the Reflex Sympathetic Dystrophy
Syndrome Association of America (RSDSA)
website. CRPS patients were invited to
participate in the survey, hosted for 6
months from October 2004 to February
2005 (
www.rsdsa.org).
Reminders were sent through e-mail to
members of RSDSA encouraging
individuals to participate in the study.
The 75-question survey was guided by
gaps in the epidemiology of CRPS and a list
of e-queries to the RSDSA website during 2
prior years.
Diagnosis/Treatment/Employment
Physicians making the initial diagnosis
Orthopedic surgeons 32% Pain specialists 19%
Diagnosis made based on
Clinical examination 45.7%
X-rays 34.7% Bone scan 35.4%
MRI 35.3% Sympathetic nerve blocks
46.4%
Pain descriptors at the disease onset
Burning 83% Sensitive to touch 80%,
Sharp 69% Shooting 57%
Aching 56%
Common drugs used to treat pain
NSAIDs 63% Gabapentin 47%,
Hydrocodone 45% Oxycodone 39%,
Cox-2 Inhibitors 38% Tramadol 37%
Morphine 29%
Interventional therapies-
Nerve blocks 68% Spinal cord stimulation 5%
Sympathectomy 6% Physical therapy 76%
Counseling 37%
Work
Work-related Injury 41%
Workmens Compensation 30.4%
Pain interfered with work 93%
Present employment status
Disabled 60% Full-time employed 16%
Part-time employed 6%
Diagnosis/Treatment/Employment
Physicians making the initial diagnosis
Orthopedic surgeons 32% Pain specialists 19%
Diagnosis made based on
Clinical examination 45.7%
X-rays 34.7% Bone scan 35.4%
MRI 35.3% Sympathetic nerve blocks
46.4%
Pain descriptors at the disease onset
Burning 83% Sensitive to touch 80%,
Sharp 69% Shooting 57%
Aching 56%
Common drugs used to treat pain
NSAIDs 63% Gabapentin 47%,
Hydrocodone 45% Oxycodone 39%,
Cox-2 Inhibitors 38% Tramadol 37%
Morphine 29%
Interventional therapies-
Nerve blocks 68% Spinal cord stimulation 5%
Sympathectomy 6% Physical therapy 76%
Counseling 37%
Work
Work-related Injury 41%
Workmens Compensation 30.4%
Pain interfered with work 93%
Present employment status
Disabled 60% Full-time employed 16%
Part-time employed 6%
Demographics of study patients N = 1359
Supported by a grant from RSDSA Supported by a grant from RSDSA
Hx of remission 21.3%
Currently in remission 18.3%
Course of
disease
California 9.3%
Pennsylvania 8.6%
Florida 7.9%
Main regions
( states)
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