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An Updated Interdisciplinary Clinical Pathway for CRPS: Report of an Expert Panel
Author(s) -
StantonHicks Michael D.,
Burton Allen W.,
Bruehl Stephen P.,
Carr Daniel B.,
Harden R. Norman,
Hassenbusch Samuel J.,
Lubenow Timothy R.,
Oakley John C.,
Racz Gabor B.,
Raj P. Prithvi,
Rauck Richard L.,
Rezai Ali R.
Publication year - 2002
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1046/j.1533-2500.2002.02009.x
Subject(s) - medicine , psychological intervention , complex regional pain syndrome , modalities , rehabilitation , guideline , scope (computer science) , intensive care medicine , physical therapy , evidence based practice , physical medicine and rehabilitation , alternative medicine , psychiatry , social science , pathology , sociology , computer science , programming language
The goal of treatment in patients with complex regional pain syndrome (CRPS) is to improve function, relieve pain, and achieve remission. Current guidelines recommend interdisciplinary management, emphasizing 3 core treatment elements: pain management, rehabilitation, and psychological therapy. Although the best therapeutic regimen or the ideal progression through these modalities has not yet been established, increasing evidence suggests that some cases are refractory to conservative measures and require flexible application of the various treatments as well as earlier consideration of interventions such as spinal cord stimulation (SCS). While existing treatment guidelines have attempted to address the comprehensive management of CRPS, all fail to provide guidance for contingent management in response to a sudden change in the patient's medical status. This paper reviews the current pathophysiology as it is known, reviews the purported treatments, and provides a modified clinical pathway (guideline) that attempts to expand the scope of previous guidelines.