Effectiveness of Decision Support to Treat Complex Regional Pain Syndrome

Background: Complex regional pain syndrome (CRPS) type 1 is a rare but disabling pain condition, usually involving distal extremities such as the wrist, hand, ankle, and foot due to either direct or indirect traumas. CRPS type 1 is characterized by a complex set of symptoms where no correlation can be identified between the severity of the initial injury and the ensuing painful syndrome. Over the years, numerous treatment strategies have been proposed for CRPS management, but therapies remain controversial. At present, no successful therapeutic intervention exists for this condition. The aim of the present study was to propose and assess the effectiveness of a rehabilitative treatment algorithm for CRPS, which is actually in use at our institution. Methods: We retrospectively reviewed all the patients that underwent physical rehabilitative treatment algorithm for hand CRPS between 2011 and 2017 at our Institution. Results: All the parameters taken into consideration, namely the Purdue Pegboard Test (PPT), Disability of the Arm, Shoulder and Hand (DASH), Visual Analog Scale (VAS), as well hand edema, were significantly improved at the end of the rehabilitation protocol. Conclusions: The results obtained in the present study demonstrated that our rehabilitation protocol was able to achieve substantial improvement in pain and quality of life scores. Thus, an early and skillful rehabilitation intervention is of paramount importance for CPRS type 1 management to achieve a stable and optimal functional recovery while preventing the onset of deformities.