An audit of patients with complex regional pain syndrome at the Helen Joseph Hospital pain management unit

Abstract

Complex regional pain syndrome (CRPS) consists of chronic pain and hyperalgesia, motor, autonomic and dystrophic disturbances. The pain and disability are out of proportion to the inciting event, appear to be lifelong and have an impact on the patients’ quality of life and socio-economically. The aetiology and diagnosis are not clearly defined and to date this syndrome has been widely studied by different specialities but few epidemiological studies have been carried out. Presently the statistics at the Helen Joseph Hospital Pain Management Unit (HJHPMU) are not known. The aim of this study was to describe the occurrence, profile and management of patients treated for CRPS at the HJHPMU. This study was retrospective, contextual and descriptive in design. The files of the patients who presented with CRPS, at the HJHPMU, from the inception of the clinic in 2005, up until the end of July 2014 were audited. The occurrence of patients with CRPS at the HJHPMU is 4.6%. The most common age group (41%) at diagnosis was 41 to 50 years. The majority of patients were females (51.3%), black patients (48.7%), married patients (53.8%) and unemployed patients (53.8%), The upper limb was dominant in 66.7%, the left side of the body in 51.3% and was due to fractures in 39.8% and surgery in 17.9% of patients. The management comprised of pharmacotherapy where analgesia was prescribed to 97.4% of patients, interventional therapy where stellate ganglion blocks were administered in 38.0% of patients and supportive therapy where physiotherapy was given to 35.1% of patients. There are a small percentage of patients with CRPS, presenting to the HJHPMU for multidisciplinary and multimodal pain management. This is in line with the occurrence found in the International studies.