J Korean Med Sci.  2008 Oct;23(5):772-775. 10.3346/jkms.2008.23.5.772.

Epidemiology of Complex Regional Pain Syndrome: A Retrospective Chart Review of 150 Korean Patients

• Choi YS
• Lee MG
• Lee HM
• Lee CJ
• Jo JY
• Jeon SY
• Lee SC
• Kim YC

• KMID: 1783059
• DOI: http://doi.org/10.3346/jkms.2008.23.5.772

Abstract

Complex regional pain syndrome (CRPS) is a chronically painful and disabling disorder. However, no data are available even on the epidemiology of CRPS in Korea. This study was undertaken to retrospectively assess the epidemiologic characteristics of CRPS in 150 consecutive patients at a tertiary chronic pain center from March 2002 to February 2006. Information was obtained regarding patients' demographics, nature of injury, and treatment modalities. Seventy-one percent of patients had CRPS type I. The mean 11-point verbal numerical rating scale score at initial examinations and at the time of study were 8.0 and 5.7, respectively. Thirty-two percent of patients showed no change or increase in pain intensity during follow-up at our pain center. The mean duration of CRPS symptoms prior to our pain center evaluation and prior to the time of study were 27 months and 50 months, respectively. These patients had seen on average 5 different physicians before being referred to our center. This study shows that the majority of CRPS patients were referred to our center after more than 2 yr of symptoms. The clinical implication of such delayed transfer and strategies to avoid this problem are discussed.

Keyword

Complex Regional Pain Syndromes; Epidemiology; Treatment

MeSH Terms

Adult
Complex Regional Pain Syndromes/*diagnosis/*epidemiology/therapy
Female
Humans
Korea
Male
Middle Aged
Pain/epidemiology
Pain Clinics
Pain Measurement/methods
Retrospective Studies
Time Factors
Wounds and Injuries/complications

Figure

• 

  Fig. 1 Distribution of cases by age and sex.

• 

  Fig. 2 Types of injuries precipitating the development of CRPS.

• 

  Fig. 3 The number of patients for each of the treatment modalities.

• 

  Fig. 4 The percent of patients who reported this treatment most effective.

Reference

1. Kim YC. Complex regional pain syndrome. Korean J Pain. 2004. 17:S104–S108.

2. Rho RH, Brewer RP, Lamer TJ, Wilson PR. Complex regional pain syndrome. Mayo Clin Proc. 2002. 77:174–180.

3. Bruehl S, Harden RN. Harden RN, Baron R, Janig W, editors. An empirical approach to modifying IASP diagnostic for CRPS. Complex regional pain syndrome. 2001. Seattle: IASP press;303–313.

4. Bruehl S, Lubenow TR, Nath H, Ivankovich O. Validation of thermography in the diagnosis of reflex sympathetic dystrophy. Clin J Pain. 1996. 12:316–325.

5. Park SH, Lee PB, Lim YH, Lee SY, Choi IY, Lee SJ, Oh YS. The usefulness of three-phase bone scan and thermography for making the diagnosis of CRPS-I. Korean J Pain. 2006. 19:81–86.

6. Allen G, Galer BS, Schwartz L. Epidemiology of complex regional pain syndrome: a retrospective chart review of 134 patients. Pain. 1999. 80:539–544.

7. Sandroni P, Benrud-Larson LM, McClelland RL, Low PA. Complex regional pain syndrome type I: incidence and prevalence in Olmsted county, a population-based study. Pain. 2003. 103:199–207.

8. Schwartzman RJ, Kerrigan J. The movement disorder of reflex sympathetic dystrophy. Neurology. 1990. 40:57–61.

9. Veldman PH, Reynen HM, Arntz IE, Goris RJ. Signs and symptoms of reflex sympathetic dystrophy: prospective study of 829 patients. Lancet. 1993. 342:1012–1016.

10. Hassantash SA, Afrakhteh M, Maier RV. Causalgia: a meta-analysis of the literature. Arch Surg. 2003. 138:1226–1231.

11. Galer BS, Schwartz L, Aller R. Loeser JD, Butler SH, Chapman CR, Turk DC, editors. Complex regional pain syndromestype I: reflex sympathetic dystrophy, and type II: causalgia. Bonica's Management of Pain. 2001. 3rd ed. Philadelphia: Lippincott Williams & Wilkins;404–408.

12. Correll GE, Maleki J, Gracely EJ, Muir JJ, Harbut RE. Subanesthetic ketamine infusion theraphy: a retrospective analysis of a novel therapeutic approach to complex regional pain syndrome. Pain Med. 2004. 5:263–275.

13. Taylor RS, Van Buyten JP, Buchser E. Spinal cord stimulation for complex regional pain syndrome: a systematic review of the clinical and cost-effectiveness literature and assessment of prognostic factors. Eur J Pain. 2006. 10:91–101.

14. Lee CJ, Kim YC, Shin JH, Yoo SY, Shin HY, Kim YH, Han SS, Joh JY, Lee EH, Lee SC, Park JH. Spinal Cord Stimulation in management of intractable chronic pain: a 5-year experience. Korean J Anesthesiol. 2006. 51:195–200.

15. Forouzanfar T, Weber WE, Kemler M, van Kleef M. What is a meaningful pain reduction in patients with complex regional pain syndrome type 1? Clin J Pain. 2003. 19:281–285.

16. Wakasugi B. Pain clinic shindan chiryou guide. 1994. Nilon Iji Shimosha;43–49.