Pediatric Complex Regional Pain Syndrome With and Without a History of Prior Physical Trauma at Onset

Area of Science:

• Pediatric Pain Management
• Neurology
• Rehabilitation Medicine

Background:

• Complex Regional Pain Syndrome (CRPS) is a debilitating condition in children.
• The role of physical trauma as an inciting event in pediatric CRPS is not fully understood.
• Investigating differences between CRPS patients with and without a history of trauma is crucial for understanding disease mechanisms.

Purpose of the Study:

• To compare clinical characteristics and outcomes of pediatric CRPS patients based on the presence or absence of an identified inciting physical traumatic event.
• To explore potential factors influencing disease presentation and resolution in pediatric CRPS.

Main Methods:

• A retrospective study of 301 children (≤18 years) diagnosed with CRPS between April 2008 and March 2021.
• Data collected included demographics, pain symptoms, functional disability, psychological history, and pain catastrophizing scores.
• Comparison between children with (Group T) and without (Group NT) a reported history of physical trauma.

Main Results:

• Of 301 children with CRPS, 95 reported prior physical trauma.
• No significant differences were found in age, sex, pain duration, pain level, function, or psychological symptoms between groups.
• Group T patients were more likely to have had a cast (43% vs 23%) and less likely to achieve complete symptom resolution (64% vs 76%).

Conclusions:

• Minimal differences exist between pediatric CRPS patients with and without a history of physical trauma.
• Immobility, such as casting, may be a more significant factor than initial trauma in pediatric CRPS.
• Psychological profiles and outcomes were largely similar between the two groups.