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28 Cards in this Set

  • Front
  • Back
What is the difference between causalgia and RSD?
Causalgia is a sustained burning pain associated with a nerve injury combined with vasomotor, sudomotor, and late trophic changes. RSD is a latent pain syndrome unrelated to nerve damage.
What are the different types of CRPS?
Type 1 (RSD)

Type 2 (Causalgia)

Type 3 (NOS)
What is allodynia?
Nonpainful stimulus provokes pain.
What is hyperalgesia?
Increased response to painful stimulus.
What is hyperpathia?
Increased response to painful stimulus that continues after the stimulus is withdrawn.
What is dyesthesia?
An unpleasant abnormal sensation.
What are the main symptoms of neuropathic pain?
Continous, spontaneous, deep cramping, aching, or throbbing, superficial burning, pinching, or stabbing, and radiating or referred pain.
Is there one accepted mechanism for CRPS?
No- there is no one accepted theory. The etiology is poorly understood. It is thought that the pain is unrelated to the SNS.
What is the incidence of CRPS?
Trauma usually involved
Identifiable lesion >50%
Rare in children/adolescents
What are the prognostication values for the classical clinical presentation of CRPS?
Stage 1- 3 mos

Stage 2- 3-9 mos

Stage 3- 9 mos or more
What diagnostic criterion factors are used for CRPS?
Symptoms and Signs (sensory changes, vasomotor changes, sudomotor changes, and motor/trophic changes)
What is the difference between symptoms and signs?
Symptoms are what a patient relays to you while signs are what is found when the patient is observed and evaluated.
What are the symptoms/signs for CRPS?
Sensory: hyperesthesia/allodynia

Vasomotor: temperature/skin asymmetry and skin color changes

Sudomotor: edema, hyperhydrosis, sweating

Motor/Trophic: decreased ROM
What are the clinical diagnosis criteria for CRPS?
Disproportionate pain

Symptom factors (3 of 4)

Sign factors (2 or more)

No other diagnosis that explains sx's

Sensitivity of 0.85 and specificity of 0.69
What diagnostic tests can be used to diagnose CRPS?
There is no gold standard as far as tests are concerned. Radiology, thermography, plethysmography, and triple phase bone scans can be utilized.
What are the most common drugs used to treat this disorder?
Alpha/beta blockers
Tricyclic antidepressants

Last two are the most commong ones.
What is the purpose of a Stellate Ganglion nerve block?
It is attempting to shut off the SNS to help stabalize the system. Used in more chronic pain states when the pain is actually maintained sympathetically.
What are some treatments utilized for CRPS?
Nerve blocks
Edema management
Functional activities
What do the different types of TENS do when treating CRPS?
Conventional- modulates pain

Burst- creates vasodilation

Brief Intense- creates vasoconstriction
Where should electrodes be placed when performing TENS on a patient with CRPS?
Proximal to the pain- do not place electrodes over spots that are hypersensitive!
What is important to remember when performing lymphatic drainage or retrograde massage on patients with CRPS?
It should not be cyclical in nature and one needs to be careful over areas that are hypersensitive.
Define dystonia.
Sustained contraction with twisting/repetition/posturing.
Define myoclonus.
Involuntary, brief, jerky movements.
Define tremor.
Rhythmic contractions at 4-12 Hz
How is dystonia treated?
An "external set" (external targeting) and EMG biofeedback are used to get the patient to use the extremity.
How is allodynia/hypersensitivity treated?
Desensitization (should be peripheral to cental, fine to coarse, etc.) Should be performed for a minimum of 20 min. and a maximum of 45 min. For the treatment to be effective a total of an hour and a half of treatment should be performed in one 24 hr. period.
How is vasomotor instability treated when vasoconsticition is present?
Heat modalities
Brief Intense TENS

Want to cause vasodilation
How is vasomotor instability treated when vasodilation is present?

Cold immersion (18 degrees for 10-15 min.)

Burst TENS

Want to cause vasoconstriction