CRPS-MANAGEMENT

SUMMARY

1. ROM exercises of the involved joints: patients respond within 3 weeks (most within 4-6 days) of passive stretch of the involved joints.

2. High-dose systemic corticosteroids: majority of patients respond to high-dose steroids instituted in the acute-phase (given over 2 weeks, followed by 2 week taper), more effective in those with disease confirmed on bone scan.

3. Medications: membrane-stabilizers (pregabalin), calcitonin, bisphosphonates, NSAIDs, TCA, alpha-blockers (prazosin), beta-blockers (propranolol), calcium-channel blockers (nifedipine), anti-convulsant (gabapentin), topical capsaicin, lidocaine patch.

4. Modalities: graded motor imagery, TENS, edema-control, desensitization techniques, contrast baths, ultrasound.

5. Injections: tender-point injections, sympathetic ganglion blocks.

6. Surgical: spinal cord stimulator insertion, sympathectomy.

Reference(s)

Cifu, D.X. (2020). Braddom’s physical medicine and rehabilitation. Elsevier. Get it on Amazon.
Cuccurullo, S. (2019). Physical medicine and rehabilitation board review. New York: Demosmedical. Get it on Amazon.
O’Young, B., Young, M.A. and Stiens, S.A. (2008). Physical Medicine and Rehabilitation Secrets. Mosby. Get it on Amazon.