Reflex sympathetic dystrophy: A multidisciplinary approach

Maillard, Susan; Davies, Karen; Khubchandani, Raju; Woo, Patricia; Murray, Kevin

doi:10.1002/art.20249

Cited by 53 publications

(44 citation statements)

References 51 publications

(74 reference statements)

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“…In this case series the patients' recovery time was 2.8 to 4 weeks on average. [23][24][25] Pain is the major factor impeding a fast recovery. There is insufficient evidence for efficacy of systemic opioids in CRPS patients.…”

Section: Discussionmentioning

confidence: 99%

Diffuse Complex Regional Pain Syndrome in an Adolescent

Cucchiaro¹,

Craig

Marks³

et al. 2013

The Clinical Journal of Pain

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Section: Discussionmentioning

confidence: 99%

Diffuse Complex Regional Pain Syndrome in an Adolescent

Cucchiaro¹,

Craig

Marks³

et al. 2013

The Clinical Journal of Pain

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“…The pediatric pain clinic follows a well-documented approach to treating pain and improving function utilizing interdisciplinary assessment and multidisciplinary interventions including medical assessment, physical therapy, and psychological interventions [15,32,39,41,52,70]. Initial evaluation occurs as follows: First, interdisciplinary team members review Peds-CHOIR results, which the patient and caregiver complete either at home or in the clinic before their appointment and discusses possible areas of vulnerability reported by the patient and their caregiver.…”

Section: Methodsmentioning

confidence: 99%

Pediatric-Collaborative Health Outcomes Information Registry (Peds-CHOIR): a learning health system to guide pediatric pain research and treatment

Bhandari

Feinstein

Huestis

et al. 2016

Pain

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The pediatric adaptation of the Collaborative Health Outcomes Information Registry (Peds-CHOIR) is a free, open source, flexible learning health care system (LHS) that meets the call by the Institute of Medicine (IOM) for the development of national registries to guide research and precision pain medicine. This report is a technical account of the first application of Peds-CHOIR with three aims: to 1) describe the design and implementation process of the LHS; 2) highlight how the clinical system concurrently cultivates a research platform rich in breadth (e.g., clinic characteristics) and depth (e.g., unique patient and caregiver reporting patterns); and 3) demonstrate the utility of capturing patient-caregiver dyad data in real time, with dynamic outcomes tracking that informs clinical decisions and delivery of treatments. Technical, financial, and systems-based considerations of Peds-CHOIR are discussed. Cross-sectional, retrospective data from patients with chronic pain (N = 352; 8 – 17 years; M = 13.9 years) and their caregivers are reported, including NIH Patient Reported Outcomes Measurement Information System (PROMIS) domains (mobility, pain interference, fatigue, peer relations, anxiety and depression) and the Pain Catastrophizing Scale. Consistent with the literature, analyses of initial visits revealed impairments across physical, psychological and social domains. Patients and caregivers evidenced agreement in observable variables (mobility); however, caregivers consistently endorsed greater impairment regarding internal experiences (pain interference, fatigue, peer relations, anxiety, depression) than patients’ self-report. A platform like Peds-CHOIR highlights predictors of chronic pain outcomes on a group level and facilitates individually tailored treatment(s). Challenges of implementation and future directions are discussed.

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“…Complex regional pain syndrome type I (CRPS), also known as reflex sympathetic dystrophy, is characterized by burning pain, allodynia, and swelling of distal extremities along with autonomic dysfunction following injury to the extremity (Box 2) [53,54]. Although most pediatric patients with CRPS present with a history of minor trauma or repeated stress injury (eg, caused by competitive sports), many are unable to identify a precipitating event [55].…”

Section: Idiopathic Musculoskeletal Pain Syndromesmentioning

confidence: 99%

“…Childhood CRPS differs from the adult form in that lower extremities are affected even more commonly in children [54,[56][57][58]. Consistent with the biopsychosocial model of pain, research has suggested that psychologic stress plays a significant role in children's disease [56,59,60], and that children may be at increased risk for development of CRPS if they have relatives with chronic pain conditions [54]. Treatment for childhood CRPS, as for other pain syndromes, seeks to improve function as much as relieve pain.…”

Section: Idiopathic Musculoskeletal Pain Syndromesmentioning

confidence: 99%