Journal of Pain & Relief
Open Access

Abstract

Complex regional pain syndrome (CRPS) is a painful syndrome, typically affecting the hand or foot. Regional pain, sensory changes (e.g. allodynia), edema and abnormal sudomotor activity, skin color and temperature that usually occurs after an initiating noxious event such as trauma are the main features. Two types of CRPS have been recognized: CRPS I corresponds to reflex sympathetic dystrophy (RSD) and occurs without a definable nerve lesion. CRPS II (causalgia) refers to a case in which a definable nerve lesion is present after a nerve injury, but the clinical picture is not limited to the distribution of the injured nerve. CRPS were regarded as rare in children until the 1970s but now it has become a well-established entity with its own characteristics. The diagnosis of CRPS can be performed on clinical judgment based on established diagnostic criteria, but the mosaic picture of this syndrome usually leads to delayed management, unnecessary investigations and improper treatment. Psychological factors contribute to the development of pediatric CRPS and sometimes a particular psychological profile can be seen. Dedicated team (pain specialist, PT/OT specialists, psychologist) is required for successful treatment. In conclusion, CRPS in children and adolescents is still underdiagnosed, although many of the epidemiologic features of pediatric CRPS are similar in different countries/cultures. Early diagnosis, appropriate referral and treatment are essential in reducing pain and improving function in children and adolescents with CRPS.

Biography

Ludmyla Kachko is a Board Certified (Israel) in Anesthesia and Pain Treatment Medicine. She joined the staff of Department of Anesthesia at Schneider Children’s Medical Center of Israel which is affiliated with Sackler Faculty of Medicine, Tel Aviv University, in 1998 as the attending Anesthesiologist, with the particular interest in Pain Treatment in children. Since 2001, she directs the Chronic Children’s Pain Clinic as a part of Pain Treatment Service of the Department of Anesthesia. Her staff employs the multidisciplinary approach to the wide range of pediatric chronic pain conditions. Since 2011, she serves as the Head of Pain Treatment Service. She has established a new program for the treatment of Complex Regional Pain Syndrome in Children in Israel in 2002, that led to high awareness, early diagnosis and shorter treatment time. She provides many lectures in Israel and abroad in the fields of Chronic Pain in children.