Korean J Pain.  2010 Dec;23(4):258-261. 10.3344/kjp.2010.23.4.258.

Physical Therapy and Rehabilitation of Complex Regional Pain Syndrome in Shoulder Prosthesis

• Celik D
• Demirhan M

• KMID: 1454710
• DOI: http://doi.org/10.3344/kjp.2010.23.4.258

Abstract

We report a 66-year-old woman with complex regional pain syndrome (CRPS) 1 treated with combined medical and active physical therapy. She was diagnosed with CRPS 1 following partial shoulder prosthesis due to proximal humerus fracture. Despite continuous medication and physical therapy, there was no improvement in her pain and functional outcome. Her overall pain was decresed by stellate ganglion block 3 times in two weeks conducted during the second month of the follow-up period. Following the ganglion blockades, pain and the other symptoms were decreased intermittently but range of motion (ROM) and functional status were not satisfied as much as expected. After the third month of follow-up, her passive and active ROM of the shoulder joint was increased after application of manipulation under general anesthesia. In conclusion, because CRPS 1 remains one of the most difficult pain syndromes, early diagnosis and treatment are important to have adequate functional results from physical therapy. Manipulation under general anesthesia may be an additional effective treatment tool to obtain functional improvement in some patients diagnosed with CRPS 1.

Keyword

CRPS; manipulation under general anesthesia; physical therapy; stellate ganglion block

MeSH Terms

Aged
Anesthesia, General
Early Diagnosis
Female
Follow-Up Studies
Ganglion Cysts
Humans
Humerus
Prostheses and Implants
Range of Motion, Articular
Shoulder
Shoulder Joint
Stellate Ganglion

Figure

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  Fig. 1 Forward flexion after 6 months.

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