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Pain dysfunction syndrome of the knee
D Neuschwander1, D Drez, S Heck
1University of Pittsburgh, School of Medicine, Pa, USA.
Orthopedics
|January 1, 1996
Summary
Differential epidural blocks help evaluate pain dysfunction syndrome, identifying central pain patterns in 50% of patients. However, even with accurate diagnosis, outcomes remain poor for compensation cases.
Area of Science:
- Pain Medicine
- Neurology
- Anesthesiology
Background:
- Pain dysfunction syndrome is characterized by excessive, nonanatomic pain disproportionate to injury.
- This condition presents diagnostic challenges, necessitating effective evaluation methods.
Purpose of the Study:
- To evaluate the effectiveness of differential epidural blocks in diagnosing pain dysfunction syndrome.
- To identify response patterns associated with differential epidural blocks in these patients.
Main Methods:
- A retrospective review of patients diagnosed with pain dysfunction syndrome.
- Utilizing differential epidural blocks to assess pain response patterns.
Main Results:
- Four distinct response patterns were identified: reflex sympathetic dystrophy (14%), somatic (9%), mixed sympathetic and somatic (27%), and central (50%).
- The majority of inciting injuries (70%) were minor strains, sprains, or contusions.
- Differential epidural blocks revealed a significant central pain component in 50% of cases.
Conclusions:
- Differential epidural blocks are effective in evaluating pain dysfunction syndrome and categorizing pain patterns.
- A substantial proportion of patients exhibit central pain mechanisms.
- Prognosis remains poor for compensation cases, irrespective of accurate diagnosis.
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