Epidemiology of complex regional pain syndrome: a retrospective chart review of 134 patients
Epidemiology of complex regional pain syndrome: a retrospective chart review of 134 patients
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DOI：
10.1016/s0304-3959(98)00246-2
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发表时间：
1999-04-01
期刊：
影响因子：
7.4
通讯作者：
Schwartz, L
中科院分区：
文献类型：
--
作者：
Allen, G;Galer, BS;Schwartz, L
复杂区域疼痛综合征(CRPS)仍然是一种知之甚少的慢性疼痛障碍。评估CRPS(和反射性交感神经营养不良，RSD)的流行病学的数据很少发表。这项研究评估了美国一家三级慢性疼痛诊所评估的134名CRPS患者的流行病学变量，包括人口统计、医疗保健利用和法律/工人补偿措施。此外，还评估了医生强制固定CRPS肢体的频率，以及肌筋膜功能障碍的体检证据。这项研究发现，这些患者在转诊到疼痛中心之前平均看过4.8名不同的医生，在疼痛临床治疗之前和期间平均接受了5种不同的治疗。疼痛中心评估前CRPS症状的平均持续时间为30个月。17%的人提起了诉讼，54%的人提出了与CRPS相关的工人赔偿要求。51名患者接受了骨扫描，但只有53%的患者被解释为符合RSD/CRPS的诊断。47%的患者有医生强制制动的病史，56%的患者在评估时存在肌筋膜成分。CRPS症状的持续时间和上肢受累与肌筋膜功能障碍的存在显著相关。因此，这项研究发现，大多数CRPS患者在经历了几年的症状和许多失败的治疗后，会被转诊到疼痛专科诊所。这些数据还表明诊断骨扫描缺乏实用性，并突出了大多数CRPS患者肌筋膜功能障碍的突出表现。(C)1999年国际疼痛研究协会。爱思唯尔科学公司出版。
Complex regional pain syndrome (CRPS) remains a poorly understood chronic pain disorder. Little data has been published assessing the epidemiology of CRPS (and reflex sympathetic dystrophy, RSD). This study assessed epidemiological variables in 134 CRPS patients evaluated at a tertiary chronic pain clinic in the US, including demographic, health care utilization and legal/workman's compensation measures. In addition, the frequency of physician-imposed immobilization of the CRPS limb was assessed, as was physical examination evidence of myofascial dysfunction. This study found that these patients had seen on average 4.8 different physicians before referral to the pain center and had received an average of five different kinds of treatments both prior to and during pain clinic treatment. The mean duration of CRPS symptoms prior to pain center evaluation was 30 months. Seventeen percent had a lawsuit and 54% had a worker compensation claim related to the CRPS. Fifty-one patients received a bone scan, but only 53% of which were interpreted as consistent with the diagnosis of RSD/CRPS. Forty-seven percent had a history of physician-imposed immobilization, and 56% had a myofascial component present at evaluation. The duration of CRPS symptoms and the involvement of the upper extremity was significantly associated with the presence of myofascial dysfunction. Thus, this study found that most CRPS patients are referred to a pain specialty clinic after several years of symptoms and many failed therapies. The data also suggest the lack of utility of a diagnostic bone scan and highlight the prominence of myofascial dysfunction in a majority of CRPS patients. (C) 1999 International Association for the Study of Pain. Published by Elsevier Science B.V.