COMPLEX REGIONAL PAIN SYNDROME. A CASE REPORT
Lourdes Trinidad Castillo Garcia, Fabiola Espinoza Romero
We present the case of a 68-year-old female patient, radio fracture in february 2018, for which she was hospitalized for a closed reduction with immobilization for 3 weeks. Patient referred Rehabilitation Consultation, with pain that began the day 2 weeks after removal of plaster for Colles fracture, the pain is oppressive on the back and palm of right hand, of intensity 8/10, presents allodynia, electrical discharges from fingers to forearm, constant tingling, denies burning, the pain intensifies to 10/10 intensity. The right upper extremity intact, hyprotrophy is observed in the forearm, back and palm of the hand, which is with erythema, smooth smooth skin, with loss of hair in forearm compared to contralateral side, mobility arcs limited by pain, strength and reflexes are not explored, patient does not allow to evaluate, allodynia in C6, C7, C8, distal predominance (forearm and hand), good capillary refill. We diagnose complex regional type II pain syndrome and start treatment with tramadol. One week later he went to a brachial plexus block via the axillary with pain 8/10, blockade was performed with lidocaine 1% 60mg + Dexamethasone 8mg without complications. Go to review a day later with good response, pain 5/10, continue with tramadol. the blockade was made 2 more times each week, with a gradual decrease in intensity of pain 2/10 of burning type that is exacerbated when carrying out daily activities. Complex regional pain syndrome (CRPS) was defined in 1993 by the International Association for the Study of Pain (IASP) as one: Variety of painful conditions of regional localization, after a lesion, presenting a distal predominance of abnormal symptoms, exceeding in magnitude and duration the expected clinical course of the initial incident, frequently causing significant motor deterioration, with a variable progression over time. The diagnosis It is done by applying Budapest criteria by the IASP. The treatment are several therapeutic approaches among which we find medical and pharmacological treatment, psychological treatment, occupational therapy, rehabilitation treatment and more recently the treatment with spinal electrical stimulation. Although the therapeutic approach of CRPS requires a multidisciplinary approach, the most important thing is that the treatment be early, individual, progressive and painless.
Cite This Article :
Article :Download PDF Article No. : 1Number of Downloads : 275