Complex Regional Pain Syndrome: Comparing Adults and Adolescents

Lorraine M. Taylor, MSN, CFNP

Disclosures

Topics in Advanced Practice Nursing eJournal. 2002;2(2) 

In This Article

Abstract and Introduction

Abstract

Complex regional pain syndrome (CRPS) has been reported and studied in adults for many years. It is a less acknowledged disorder in children, probably due to underdiagnosis. The presentation and response to treatment of CRPS differs in the adolescent as compared with the adult form. In both the adolescent and adult with CRPS, the single best prognostic indicator is early recognition and treatment. The purpose of this paper is to highlight these differences and educate healthcare providers in an attempt to positively affect the outcome of this potentially devastating disease. An illustrative case is reported.

Introduction

CRPS, formerly known as reflex sympathetic dystrophy (RSD), refers to a debilitating neuropathic pain disorder. Continuous severe burning pain and vasomotor instability that has been attributed to autonomic nervous system dysfunction are the primary manifestations of the syndrome. CRPS usually affects an extremity, but can affect any part of the body.[1] It has been recognized and reported in adults since the days of the American Civil War, but it was not until the 1970s that it was acknowledged as an entity in children.[2,3] Currently, CRPS is defined as a syndrome because it may include more than 1 disease entity.[4] The diagnostic criteria and treatment modalities of CRPS have long been a matter of controversy and debate due to the poorly understood pathophysiology. It has, however, been recognized that this syndrome differs significantly in adolescents in its presentation and its response to treatment as compared with adults.[3,5,6,7,8,9,10,11,12] Although uncommon in the pediatric population, CRPS is not rare. Left untreated, the symptoms can become chronic, spread to other parts of the body, and persist for years.The earlier it is recognized and treated, the better the prognosis.[1]

The purpose of this paper is to highlight some known differences between the adult and childhood forms of CRPS in an attempt to educate healthcare providers who often see these cases early in the course of the disease. Nurse practitioners and other advanced practice nurses are in an ideal position to affect the outcome of this disease by early diagnosis and proper treatment. CRPS may even be prevented by early recognition of key signs and symptoms and appropriate early intervention.

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