Journal Article

OP15 Complex regional pain syndrome case characteristics and treatment patterns: a retrospective institutional registry study

Richman, Daniel, Gungor Semih, Chen, Tina, Malhotra Anuj, Komatz Marlena, Chan, William, Sideris, Alexandra, Xu, Victoria

2025

Overview

Background and AimsComplex Regional Pain Syndrome (CRPS) is a rare, debilitating pain condition often attributed to distinct inciting events, long-term overuse, or no obvious cause. Variable presentation makes consistent assessment, diagnosis, and treatment of CRPS difficult. To understand how pain management providers diagnose and treat CRPS patients, we created an automated analytical electronic health record (Epic)-based registry to capture new patient encounters with qualifying diagnoses, including CRPS. A retrospective chart review was manually conducted to investigate demographics, clinical characteristics, and treatment regimens of CRPS patients.MethodsAfter IRB approval, patients diagnosed with neuropathic pain or CRPS between January 20th, 2022, and November 28th, 2023 were identified using CRPS ICD-10 codes from an institutional Epic-based registry. Data elements were manually extracted from Epic and collected in REDCap. Descriptive statistics were used to summarize data that includes patient demographics, co-morbidities, diagnostic details, and subsequent treatments.Results100 patients were reviewed at the time of abstract submission and their characteristics are summarized in table 1. Commonly reported symptoms at diagnosis were hyperalgesia/allodynia (64%), skin color asymmetry (63%), and asymmetric edema (67%) (table 2). Probable inciting events included lower extremity surgery (54%), fracture (12%), and trauma without fracture (33%) (table 3). The most commonly prescribed medication was gabapentin (34%), while the most frequently performed procedure was the lumbar sympathetic block (44%).Abstract OP15 Table 1Demographics and history of present illness of 100 registry patients qualifying with CRPSAbstract OP15 Table 2Budapest criteria patient-reported symptoms and observable signs during initial visit assessment for 100 registry patientsAbstract OP15 Table 3Probable inciting events preceding symptomatic CRPS onset, as reported by 100 registry patients during initial assessmentConclusionsContrary to existing literature, CRPS of the lower extremities was more common than that of the upper extremities in our registry patients. Pain was commonly managed using sympathetic blocks and anticonvulsant medications. Ongoing analyses include examination of CRPS subtype-specific treatments, trends in the use of off-label medications, and the effectiveness of various treatments.

• Publisher: BMJ Publishing Group LTD
• Subject: Chronic pain / Demographics / Patients