title: Short-Term Functional, Emotional, and Pain Outcomes of Patients with Complex Regional Pain Syndrome Treated in a Comprehensive Interdisciplinary Pain Management Program.
abstract: BACKGROUND
  Complex regional pain syndrome (CRPS) is difficult to effectively treat with unimodal approaches.
  
  
  OBJECTIVE
  To investigate whether CRPS can be effectively treated in a comprehensive interdisciplinary pain management program.
  
  
  METHODS
  Observational cohort study of 49 patients aged 18-89 who fulfilled 'Budapest Criteria' for CRPS and completed an interdisciplinary pain management program. Preprogram to postprogram changes in physical functioning, perceived disability, emotional functioning, acceptance, coping, and pain were assessed. The measures used included: Pain Disability Index, Six minute walk test, 2-minute sit-to-stand, Numerical Rating Scale, Center for Epidemiologic Studies Depression Scale, Pain Anxiety Symptoms Scale, Chronic Pain Acceptance Questionnaire, Coping Strategies Questionnaire-Revised, RIC- Multidimensional Patient Global Impression of Change (RIC-MPGIC), and Medication Quantification Scale. For worker's compensation patients, the rate of successful release to work at the end of the program was calculated.
  
  
  RESULTS
  Results indicated significant improvements in physical functioning and perceived disability (P's<0.001). Patients reported increased usage of an adaptive coping strategy, distraction (P = 0.010), and decreased usage of maladaptive and passive strategies (P's < 0.001). Patients showed greater chronic pain acceptance (P's ≤ 0.010) and reductions in emotional distress (P's < 0.001). Medication usage at 1-month follow-up was significantly reduced compared to program start (P < 0.001) and discharge (P = 0.004). Patients reported "much improvement" in overall functioning, physical functioning, mood, and their ability to cope with pain and flare-ups (RIC-MPGIC). Patient report of pain was not significantly reduced at discharge (P =0.078). Fourteen (88%) of 16 total worker's compensation patients were successfully released to work at the end of the program.
  
  
  CONCLUSIONS
  This study demonstrates short-term improvements in physical and emotional functioning, pain coping, and medication usage. These findings are consistent with the rehabilitation philosophy of improving functioning and sense of well-being as of equal value and relevance to pain reduction.
authors.affiliation: Department of PM&R, Northwestern Feinberg School of Medicine/the Rehabilitation Institute of Chicago, Chicago, Illinois, USA.
authors.forename: Zachary L
authors.initials: ZL
authors.lastname: McCormick
authors.affiliation: Department of PM&R, Northwestern Feinberg School of Medicine/the Rehabilitation Institute of Chicago, Center for Pain Management, Chicago, Illinois, USA.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Gagnon
authors.affiliation: Department of PM&R, Northwestern Feinberg School of Medicine/the Rehabilitation Institute of Chicago, Chicago, Illinois, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Caldwell
authors.affiliation: Department of PM&R, Northwestern Feinberg School of Medicine/the Rehabilitation Institute of Chicago, Chicago, Illinois, USA.
authors.forename: Jaymin
authors.initials: J
authors.lastname: Patel
authors.affiliation: Alliant International University, San Francisco, CA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Kornfeld
authors.affiliation: Department of PM&R, Northwestern Feinberg School of Medicine/the Rehabilitation Institute of Chicago, Center for Pain Management, Chicago, Illinois, USA.
authors.forename: James
authors.initials: J
authors.lastname: Atchison
authors.affiliation: Swedish Medical Center, Seattle, Washington, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Stanos
authors.affiliation: Department of PM&R, Northwestern Feinberg School of Medicine/the Rehabilitation Institute of Chicago, Center for Pain Management, Chicago, Illinois, USA.
authors.forename: R Norman
authors.initials: RN
authors.lastname: Harden
authors.affiliation: Department of PM&R, Northwestern Feinberg School of Medicine/the Rehabilitation Institute of Chicago, Center for Pain Management, Chicago, Illinois, USA.
authors.forename: Randy
authors.initials: R
authors.lastname: Calisoff
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D020918:Complex Regional Pain Syndromes / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D003863:Depression / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement / Q000379:methods; D010348:Patient Care Team / Q000458:organization & administration*; D020127:Recovery of Function; D016896:Treatment Outcome; D055815:Young Adult
keywords: Complex Regional Pain Syndrome; Interdisciplinary Pain Management; Pain Management; Rehabilitation