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Revista de la Sociedad Española del Dolor

versión impresa ISSN 1134-8046

Resumen

TABACH-APRAIZ, A.; LORENA-OYANADEL, M.; GUTIERREZ-ESPINOZA, H.  y  BUENO-BUKER, D.. Effects of multimodal treatment in patients with complex regional pain syndrome type 1 with, at least, 6 months of evolution: a descriptive study. Rev. Soc. Esp. Dolor [online]. 2019, vol.26, n.1, pp.6-13. ISSN 1134-8046.  https://dx.doi.org/10.20986/resed.2018.3651/2018.

Objectives:

The main objective of this work is to describe the changes in pain after a multimodal treatment scheme in patients with Complex Regional Pain Syndrome type 1 (CRPS 1), with more than 6 months of evolution, who enter treatment at the Physical Medicine and Rehabilitation Service of the San Borja Arriarán Clinical Hospital.

Material and method:

Series of cases of patients with suspicion or diagnosis of CRPS 1 who were admitted for management to the Non-Oncological Chronic Pain Unit, who underwent pain assessments through the Visual Analogue Scale (VAS) and the Chronic Pain Grade Questionnaire, functionality of the upper extremity (UE) with Quick DASH and the Lower Extremity Functional Scale Functional Scale for lower extremities (LE), at the time of admission and in follow-up after two months of multimodal management by an interdisciplinary team.

Results:

The sample consisted of 14 patients, 6 had a compromise of UE and 8 of LE, in a greater percentage of women, with an average time for the diagnosis of 14.6 months and average time of evolution at the time of admission of 19.8 months. After the treatment, the VAS showed a statistically and clinically significant decrease (2.2 cm with a DS of 2.1 [p = 0.0018]). The variable Quick DASH showed a reduction of 20.5 points with a DS of 20.2 (p = 0.0558) and the variable LEFS an increase of 13.9 points with a DS of 20.8 (p = 0.1008), both differences are not statistically significant but both with Minimal Clinically Important Difference relevant. Moderate correlation was demonstrated but it is not statistically significant between the time of evolution and the intensity of the pain presented by the patients prior to the start of the multimodal treatment.

Conclusions:

The multimodal interventions guided by Physiatrist in an interdisciplinary team in the management of the CRPS allowed to demonstrate, after a period of follow-up, clinically significant changes in pain reduction and improvement in functionality, with a decrease also in aspects of associated disability.

Palabras clave : Complex regional pain sydrome type 1; multimodal treatment; chronic pain; visual analogue scale.

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