Short-Term Functional, Emotional, and Pain Outcomes of Patients with Complex Regional Pain Syndrome Treated in a Comprehensive Interdisciplinary Pain Management Program

McCormick, Zachary L.; Gagnon, Christine M.; Caldwell, Mary; Patel, Jaymin; Kornfeld, Sarah; Atchison, James; Stanos, Steven; Harden, R. Norman; Calisoff, Randy

doi:10.1111/pme.12817

Cited by 45Pain Management and TreatmentMusculoskeletal pain and rehabilitationMedical Practices and Rehabilitation

Short-Term Functional, Emotional, and Pain Outcomes of Patients with Complex Regional Pain Syndrome Treated in a Comprehensive Interdisciplinary Pain Management Program

McCormick, Zachary L., Gagnon, Christine M., Caldwell, Mary, Patel, Jaymin, Kornfeld, Sarah, Atchison, James, Stanos, Steven, Harden, R. Norman +1 more·2015·Pain Medicine

DOI 10.1111/pme.12817

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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. DESIGN: 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.

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An interdisciplinary treatment is widely accepted for CRPS patient rehabilitation, but the content varies.
“An interdisciplinary treatment is widely accepted for CRPS patient rehabilitation, but the content varies [5-7].”
From Symptom reduction and improved function in chronic CRPS type 1 after 12-week integrated, interdisciplinary therapy (2019) · cites this paper as [7]
Another recent study, a 4-week outpatient interdisciplinary pain management program, showed improvements in physical and emotional functioning in 49 CRPS patients, but pain intensity did not decrease significantly.
“Another recent study, a 4-week outpatient interdisciplinary pain management program, showed improvements in physical and emotional functioning in 49 CRPS patients [7]; again, pain intensity did not decrease significantly.”
From Symptom reduction and improved function in chronic CRPS type 1 after 12-week integrated, interdisciplinary therapy (2019) · cites this paper as [7]
In general, it is common in CRPS interdisciplinary studies not to find much change in pain intensity, but rather in function.
“In general, it is common in CRPS interdisciplinary studies not to find much change in pain intensity, but rather in function [6, 7].”
From Symptom reduction and improved function in chronic CRPS type 1 after 12-week integrated, interdisciplinary therapy (2019) · cites this paper as [7]
In that recent study, there were changes towards more adaptive coping with pain and acceptance of pain.
“There were changes towards more adaptive coping with pain and acceptance of pain.”
From Symptom reduction and improved function in chronic CRPS type 1 after 12-week integrated, interdisciplinary therapy (2019) · cites this paper as [7]

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(530) Functional, emotional, and pain outcomes of patients with Complex Regional Pain Syndrome treated in a comprehensive interdisciplinary pain management program
Caldwell, M., McCormick, Z. L., Patel, J., Gagnon, C. M., Kornfeld, S., Stanos, S. P., Atchison, J. W., Harden, R. N., & Calisoff, R. L. (2015) · Journal of Pain · doi:10.1016/j.jpain.2015.01.450
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Authors: McCormick, Z. L., Gagnon, C. M., Caldwell, M., Patel, J., Kornfeld, S., Atchison, J., Stanos, S., Harden, R. N., & Calisoff, R.
Affiliations: Northwestern University (US)
Alliant University (US)
Swedish Medical Center (US)
Corresponding author: McCormick, Zachary L.
ORCID: McCormick, Zachary L.
Venue: Pain Medicine
Publisher: Oxford University Press (OUP)
Published: 2015-12
Volume: 16
Issue: 12
Pages: 2357-2367
ISSN: 1526-2375 (ISSN-L)
1526-4637
DOI: 10.1111/pme.12817
OpenAlex: W2132475071
Cited by: 45
References: 76
Citations by year: 2026: 1 · 2025: 5 · 2024: 4 · 2023: 6 · 2022: 5 · 2021: 6 · 2020: 3 · 2019: 7 · 2018: 3 · 2017: 2 · 2016: 3
FWCI: 3.48
Type: journal article
Language: en
Open access: closed
Licence: doi.wiley.com/10.1002/tdm_license_1 (tdm)
Locations: Pain Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
Keywords: complex regional pain syndrome, multidisciplinary pain management, physical function, disability, emotional functioning, pain acceptance, coping strategies, analgesic use, workers' compensation, return to work, Budapest criteria, chronic pain
MeSH terms: Adaptation, Psychological, Adolescent, Adult, Aged, Aged, 80 and over, Depression, Female, Humans, Male, Middle Aged, Pain Measurement, Patient Care Team, Cohort Studies, Treatment Outcome, Recovery of Function, Complex Regional Pain Syndromes, Young Adult, Pain Management

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Short-Term Functional, Emotional, and Pain Outcomes of Patients with Complex Regional Pain Syndrome Treated in a Comprehensive Interdisciplinary Pain Management Program

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