Pain and Integrative Strategies

Question 1

CRPS

Answer 1

C omplex (signs/symptoms are dynamic)
R egional (extend beyond area of injury)
P ain (disproportional)
S yndrome (occurs in variable combinations)

Question 2

CRPS Type I

Answer 2

known as the traditional RSD

occurs without an identifiable nerve injury

Question 3

CRPS Type II

Answer 3

known as causalgia

there is nerve involvement

Question 4

allodynia

Answer 4

pain that is disproportionate to the event (pain with a stimulus that is not normally painful)

Question 5

hyperpathia

Answer 5

abnormally painful reaction to a stimulus

often includes extended duration of pain, frequently with delay

Question 6

hyperalgesia

Answer 6

increased sensitivity to stimulation

Question 7

CRPS - pain symptoms

Answer 7

severe, constant, burning, throbbing, tearing, cutting, shooting and/or deep aching pain
allodynia is common

Question 8

CRPS - skin color

Answer 8

white, red, blue

Question 9

CRPS - skin changes (8)

Answer 9

1. shiny
2. dry/scaly
3. brittle nails
4. hair may grow course
5. temp difference between extremities
6. sweating
7. swelling
8. movement disorders

Question 10

CRPS - “STAMP”

Answer 10

Sensory Trophic Autonomic Motor Pain

1. Sensory (allodynia, hypo/hyperalgeisa, hypo/hyperesthesia)
2. Trophic (skin, hair, nail changes)
3. Autonomic (swelling, edema, sweating)
4. Motor (weakness, contractures, atrophy)
5. Pain

Question 11

CRPS - diagnostic tests (3)

Answer 11

1. Triple Phase Bone Scan
2. thermography
3. sympathetic blocks

Question 12

Horner’s sign

Answer 12

droopy eye from Stellate Ganglion Nerve Block
good sign - means good block
temporary
may also be hoarse

Question 13

CRPS - things to note (2)

Answer 13

1. the symptoms may spread

2. bone changes may occur

Question 14

CRPS treatment team (4)

Answer 14

1. physician
2. pain management
3. psychology
4. rehab

Question 15

CRPS - OT (6)

Answer 15

1. education
2. ADLs
3. modalities
4. pain management
5. functional range (encourage movement and ROM)
6. patient advocate

Question 16

CRPS - non-invasive treatment (6)

Answer 16

1. ultrasound
2. TENS
3. massage
4. desensitization
5. mirror box therapy
6. stress loading

Question 17

CRPS - stress loading program

Answer 17

Watson and Carlson

scrub followed by carrying