Intense Pain After Wrist Fracture - Predicting CRPS

Today's guest post if from Richmond Stace, The Specialist Pain Physio.

A recent study concluded that “… excessive baseline pain in the week after wrist fracture greatly elevates the risk of developing CRPS. Clinicians can consider a rating of greater than 5/10 to the question “What is your average pain over the last 2 days?” to be a “red flag” for CRPS”.

Most of what we need to know as clinicians comes from what the patient says. I have written previously about the importance of the narrative and taking heed. It appears from this study that paying attention to the early levels of pain after a wrist fracture can indicate a risk for developing complex regional pain syndrome.

Pain is poorly understood, especially more complex and persisting pain. Raising the level of pain understanding is fundamental to its treatment and for sufferers to overcome their problems. In knowing that intense pain (more than 5/10) could be a sign that CRPS is developing, the right action can be taken early and thereby prevent the condition evolving uncontrollably.

Of course the intensity of pain is but one dimension and clinicians should observe other characteristics of protection to design a comprehensive rehabilitation programme — e.g. inflammatory signs, posturing, behaviours and language to name but a few; this in the name of tackling the problem of pain more efficiently and successfully.

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Great post Richmond! I thought this study was interesting because while we should be using Pain Science Education as part of our daily clinical interactions, for those with intense pain that is not abating after a hand/wrist trauma, you should probably focus solely on reducing their fear avoidance through education rather than other more traditional interventions.

A review of recent CRPS research can be found on Richmond's blog here. For Richmond's recent interview and his thoughts on chronic pain, education and more, click here!

Keeping it Eclectic...