title: Complex regional pain syndrome type I in the upper extremity - how efficient physical therapy and rehabilitation are.
abstract: OBJECTIVE
  To evaluate the effects of early started combined therapy in Complex Regional Pain Syndrome-1 (CRPS-1) on the upper extremities.
  
  
  METHODS
  The study included 36 patients in the first stadium of CRPS-1 on the upper extremities The mean age of patients was 42.6±14.6, the majority of them (26 of 36) were females. The right side of the upper extremity was affected much more then the left side. They were treated by combined therapy including analgetics, electrotherapy, magneto therapy and kinesitherapy. The average length of observation was 172.1 days (from 90 to 250 days). The average length of treatment was 91.5±42.16 days. Intensity of pain, swelling of the extremity, the change in skin coloration and cutaneous manifestations were assessed three times, at the beginning of the treatment, after 6 weeks and at the end of the treatment.
  
  
  RESULTS
  The pain was registered in all patients at visit 1 (average pain intensity was 5.70 ±1.44 on 100 mm visual analogue scale), and it was progressively decreased during the treatment from 3.60±1.22 at the second visit to 0.34±0.68 at the third visit. Vasodilatation was registered in 30 (83.33%) patients and skin temperature asymmetries was found in 21 (58.33%) patients. The difference of size was detected in 30 (83.33%) patients at the first visit compared to four (11.11%) patients at the end of the treatment. There were six (16.66%) patients without swelling at the beginning compared to 26 (72.22%) at the end of the treatment (p less than 0.000). Complete healing was achieved in 32 patients (88.88%).
  
  
  CONCLUSIONS
  The carefully chosen physical agents in combination with analgesic and non-steroidal anti-inflammatory drugs may benefit in patients with CRPS-1 on the upper extremity if the treatment starts as soon as possible.
authors.affiliation: Center for Physical Medicine and Rehabilitation, Clinical Center, Kragujevac, Serbia. tanjalukovic_kg@yahoo.com
authors.forename: Tanja
authors.initials: T
authors.lastname: Zečević Luković
authors.forename: Branko
authors.initials: B
authors.lastname: Ristić
authors.forename: Zorica
authors.initials: Z
authors.lastname: Jovanović
authors.forename: Nemanja
authors.initials: N
authors.lastname: Rančić
authors.forename: Dragana
authors.initials: D
authors.lastname: Ignjatović Ristić
authors.forename: Saša
authors.initials: S
authors.lastname: Cuković
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D012019:Reflex Sympathetic Dystrophy / Q000534:rehabilitation / Q000628:therapy*; D034941:Upper Extremity
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal