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43. Kongress der Deutschen Gesellschaft für Rheumatologie, 29. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie, 25. Wissenschaftliche Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie

02.-05. September 2015, Bremen

Pain and functional impairment in children with chronic regional pain syndrome compared to generalized chronic pain at presentation and 12-month-follow-up

Meeting Abstract

  • Nathalie Jäger - Deutsches Zentrum für Kinder- und Jugendrheumatologie, Garmisch-Partenkirchen
  • Boris Hügle - Deutsches Zentrum für Kinder- und Jugendrheumatologie, Garmisch-Partenkirchen
  • Elisabeth Wollesen - Deutsches Zentrum für Kinder- und Jugendrheumatologie, Garmisch-Partenkirchen
  • Elisabeth Schnöbel-Müller - Deutsches Zentrum für Kinder- und Jugendrheumatologie, Garmisch-Partenkirchen
  • Martin Offenbächer - Institut für Medizinische Psychologie, Klinikum der Ludwig-Maximilians-Universität, München
  • Johannes Peter Haas - Deutsches Zentrum für Kinder- und Jugendrheumatologie Zentrum für Schmerztherapie junger Menschen, Garmisch-Partenkirchen

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. 43. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh); 29. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh); 25. wissenschaftliche Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). Bremen, 02.-05.09.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocKR.16

doi: 10.3205/15dgrh140, urn:nbn:de:0183-15dgrh1401

Veröffentlicht: 1. September 2015

© 2015 Jäger et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Introduction: Chronic regional pain syndromes (CRPS) are rare in childhood. Their impact on quality of life and physical functioning has been described, but not yet compared to generalized chronic pain syndromes.

The objective of this study was to determine if pediatric patients with CRPS differ from those with generalized muskuloskeletal pain syndromes in pain intensity and functional impairment.

Methods: From December 2007 to November 2010, consecutive inpatients at the German Center for Pediatric Rheumatology admitted for multimodal treatment intervention were prospectively enrolled into a dedicated database. Patients were included with confirmed diagnosis of generalized musculoskeletal pain (GMSP, Yunus & Masi criteria)or CRPS. The following data was extracted from the database: age, gender, duration of symptoms, pain (numeric rating scale), functional impairment (Functional Disability Index, FDI, and Childhood Health Assessment Questionnaire, C-HAQ) at presentation and 8 weeks after admission. Data were analyzed using descriptive statistics and non-parametric methods (Mann-Whitney-U-Test, Wilcoxon signed rank test), where appropriate.

Results: 18 Patients with CRPS and 61 with GMSP were extracted from the database (CRPS: 84% female, GMSP 81%). Median age was 11 years in CRPS vs. 14 in GMSP. Patients with CRPS had a median of 3 months of symptoms prior to admission, compared to 24 in GMSP. Patients with CRPS had comparable levels of pain on admission to GMSP (median 6.5 vs. 7, p=0.821), but significantly more functional impairment (FDI: 21.5 vs. 19 , p=0.001; C-HAQ: 1.0625 vs. 0.25 , p<0.001). 8 weeks after treatment, patients with CRPS had similar reductions in levels of pain (2 vs. 5, p=0.324), but lower functional impairment (FDI: 3 vs. 14 , p=0.003; C-HAQ: 0 vs. 0.25, p=0.068). Patients with CRPS showed significant improvement in both pain (p=0.004) and functional impairment (FDI p=0.003, C-HAQ p=0.001), while patients with GMSP profited significantly regarding pain (p<0.0001), but not in functional impairment (FDI=0.066, C-HAQ p=0.66).

Conclusion: Patients with CRPS show comparable levels of pain, but higher functional impairment. Multimodal treatment leads to comparable reduction in pain, but marked functional improvement compared to patients with GMSP. This might be related to the more pronounced functional disturbance and the shorter duration of symptoms usually observed in CRPS.