[Annie Poo]

Pain Physician. 2004 Apr;7(2):203-9., Singh G, Willen SN, Boswell MV, Janata JW, Chelimsky TC.

The value of interdisciplinary pain management in complex regional pain syndrome type I: a prospective outcome study.
Pain Medicine Fellow, Department of Neurology, University Hospitals of Cleveland and Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106.

BACKGROUND: Complex regional pain syndrome (CRPS) type I is a symptom complex of severe, chronic limb pain, often associated with allodynia, vasomotor, and sudomotor changes. Optimal management of this condition is not well understood. The role of a traditional, comprehensive pain management program with long-term follow-up has not been evaluated. OBJECTIVE: To define the benefit of the interdisciplinary approach in patients with CRPS type I. DESIGN: Prospective, case series, outcomes evaluation. METHODS: Patients with a diagnosis of CRPS type I entering the University Pain Center's intensive, outpatient pain management program were enrolled in an objective assessment study through the duration of the program, with a follow-up of 2 years. This program involved 4 weeks of interdisciplinary management comprised of 20 sessions of physical therapy, 20 sessions of occupational therapy, 12 sessions of water therapy, 20 sessions of group psychotherapy, stellate ganglion blocks, and drug therapy. OUTCOME MEASURES: Specific objective measurements of upper extremity function, sensation and strength over time, and functional status 2 years after program completion. RESULTS: Upper extremity weight tolerance increased dramatically by 29-pounds (p<0.05). Function improved, with a 35 inch-pound gain in BTE (Baltimore Therapeutic Equipment) extension (p<0.005) and a 50 inch-pound increase in flexion (p<0.02). Jebsen-Taylor multifunctional testing (fine and gross motor skills) normalized from 72 to 48 seconds (p<0.04). Stable anxiety levels despite increased patient effort implied improved pain tolerance. At the 2-year follow up, 75% of the patients were employed. CONCLUSION: Patients with CRPS type I may benefit from a 4-week outpatient pain management program emphasizing rehabilitation.

[Annie Poo]

Oops, just noticed it's not a 2006 paper.

[coachV]

no apology needed......it's still interesting......the idea that given intensive treatment, EARLY in the disease process, many rsd patients remain functional......now if we could only get work/comp or other disabilty insurance groups to recognize that putting out the money up front will save big bucks later on!!

thx for all the info!

[ATallOne]

If in fact we could get not only Insurance Companies, Worker's Comp but Doctors as well to recognize the seriousness of diagnosing RSD early on imagine the benefits all the way around. Especially for us the patients. I was tossed around like a male stripper at a "Bachelorette Party" for about a year before anyone finally took my RSD seriously. Than it was was too late. The damage was done. My RSD damage that is! You ladies are terrible! Anyway, Once the doctors did finally get off there duffs the RSD had already started spreading, the flare ups were more frequent and the pain was constant. If in fact it had been diagnosed from the onset, I'm convinced I would definitely be so much better off today. Lets hope the future will be better for others and we can help them from our mistakes! Chin Up Everyone!!!
Mark