Demography and Treatment of Complex Regional Pain Syndrome Among Children

Martin Lehmann Boesen,Anne Estmann Christensen

doi:10.11648/j.ajcem.20200801.12

Martin Lehmann Boesen, Anne Estmann Christensen

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https://doi.org/10.11648/j.ajcem.20200801.12

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Abstract

Introduction: Complex Regional Pain syndrome (CRPS) is a rare chronic pain syndrome characterized by amplified pain and autonomic dysfunction. A systematic multidisciplinary treatment program for affected children exists at our department. This study aims to estimate the incidence of CRPS and describe the demography, symptoms and psychosocial characteristics of the patients and evaluate the treatment results. Method: A retrospective medical chart review of all patients under the age of 16 years treated for CRPS between 2004 and 2014 at Hans Christian Andersen Children Hospital. Results: A total of 29 children fulfilled the diagnostic criteria for CRPS. The mean incidence was 2,4/100.000 children per year. Most patients were girls (90%) with a median age of 11 years. A lower extremity was most often involved (86%). Time to diagnosis had a mean of 174 days. All patients reported complete disappearance or significant reduction of pain at discharge without any medication. Walking was normalized in 75% and almost 1/3 could run normally. School attendance and social life was restored. Conclusion: The typical child with CRPS is a girl of normal stature, around 11 years old, who is affected by intolerable pain in a lower extremity and has severe limitation in walking. The condition is rare with a mean incidence of 2,4/100.000 children. Attention is important in order to reduce the diagnostic delay. Our treatment program was successful as the children were in reduced pain, gaining normal physical function and out of social isolation at completion of the program.

Highlights

Complex Regional Pain syndrome (CRPS) is a rare chronic pain syndrome characterized by amplified pain and autonomic dysfunction
From 2004 to December 2014, 29 children were identified fulfilling the diagnostic criteria for CRPS equaling a mean incidence of 2,4 per 100.000 children annually
Demography and treatment results of childhood CRPS in Denmark

Summary

Introduction

Complex Regional Pain syndrome (CRPS) is a rare chronic pain syndrome characterized by amplified pain and autonomic dysfunction. Conclusion: The typical child with CRPS is a girl of normal stature, around 11 years old, who is affected by intolerable pain in a lower extremity and has severe limitation in walking. Our treatment program was successful as the children were in reduced pain, gaining normal physical function and out of social isolation at completion of the program. Complex regional pain syndrome (CRPS), earlier known as reflex sympathetic dystrophia, is a seldom, but chronic and invalidating pain syndrome that may affect both children and adults. Abnormal vasomotor function with changes in skin color and/or temperature and swelling of the affected area are typical features of CRPS. This makes it different from other chronic pain syndromes. CRPS type I often evolves after immobilization suggesting the need for a triggering factor in susceptible children [4] but the pathogenesis of CRPS remains unknown

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