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The following is a summary of “Monitoring Everyday Upper Extremity Function in Patients with Complex Regional Pain Syndrome: A Secondary, Retrospective Analysis from ncRNAPain,” published in the August 2024 issue of Pain by Kindl et al.

A rare complication related to limb injury is defined as Complex Regional Pain Syndrome (CRPS). The DASH questionnaire (Disabilities of the Arm, Shoulder, and Hand) evaluated everyday arm function.

Researchers conducted a retrospective study to estimate the DASH and its sub-items compared to patients with brachial plexus lesions or fracture controls. Over time, data about active range of motion (ROM) was analyzed to determine patients’ impairment and trajectory. 

They used a dataset including 193 patients with upper extremity CRPS from the noncoding RNA (ncRNA) Pain cohort, 36 fracture controls, and 12 patients with traumatic brachial plexus lesions. Questionnaires and a goniometer for measuring ROM were utilized for clinical and psychological characterization, and 33 patients were followed up after  2.5 years of treatment.

The results showed a similar mean DASH score of patients with CRPS of 54.7 (standard deviation [S.D.] ±21) as patients with brachial plexus lesions (M = 51.4, S.D. ±16.1) different from fracture controls (M = 21.2, S.D. ± 21.1). DASH scores were predicted by pain and older age. Activities directing force or influence on the arm, shoulder, or hand were most affected in patients with CRPS. After 2.5 years of treatment, the mean DASH score decreased to 41.3 (S.D. ±25.2), weakness in leisure activities improved, pain decreased, and ROM, such as wrist flexion, recovered by 36°, benefiting two-thirds of patients in both DASH scores and ROM.

They concluded that CRPS disables the complete loss of arm function in brachial plexus lesions and shows only partial recovery. 

Source: onlinelibrary.wiley.com/doi/full/10.1155/2024/9993438