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Widespread Pain in Patients with Complex Regional Pain Syndrome
Author(s) -
Birley Thomas,
Goebel Andreas
Publication year - 2014
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 - 10.1111/papr.12092
Subject(s) - medicine , complex regional pain syndrome , cohort , referral , headaches , physical therapy , concomitant , incidence (geometry) , retrospective cohort study , neuropathic pain , anesthesia , surgery , physics , family medicine , optics
Objectives Our goal was to ascertain the prevalence of widespread pain in our cohort of patients with complex regional pain syndrome ( CRPS ). Methods We conducted a retrospective analysis of clinical letters and notes. We assessed data from consecutive patients diagnosed with CRPS according to the B udapest criteria, after a referral to one consultant at a tertiary P ain M edicine referral center. Results Between J uly 2007 and S eptember 2012, 190 patients (149 females) received a diagnosis of CRPS according to the Budapest criteria, and an additional 26 patients received the diagnosis of CRPS NOS (not otherwise specified). The CRPS patients were an average of 44 years of age, and had a median disease duration of 18 months. Before the CRPS incident trigger, a third had already experienced other than everyday pains in the now CRPS ‐affected limb. Twenty‐one patients (11.1%) experienced widespread pain in clinic, which was often not communicated in the referral letters. The types of triggering traumata and frequencies of Budapest signs and symptoms did not differ between patients with or without widespread pain. All patients considered their widespread pain as an important factor affecting their quality of life; for the majority it was of similar severity to the CRPS pain. Additional patients reported CRPS ‐concomitant regional pains, most commonly headaches/migraines, lower back pain, and irritable bowel syndrome. Discussion In this systematic assessment of the incidence of widespread pain in a large cohort of patients with CRPS , important widespread pain affected > 10% of patients. Our data support the inclusion of routine enquiries about additional pains in the clinical assessment of patients with CRPS .