Wolters Kluwer Health This website uses cookies. The information was verified by the guideline developer on April 30, 2018.Complex regional pain syndrome (CRPS), formerly known as reflex sympathetic dystrophyTo provide advisory and educational guidelines for the treatment of complex regional pain syndrome/reflex sympathetic dystrophy that are enforceable under the Colorado Workers' Compensation Rules of ProcedureIndividuals qualifying under Colorado's Workers' Compensation Act as injured workers with complex regional pain syndrome (CRPS), formerly known as reflex sympathetic dystrophy (RSD)See specific sections of the original guideline document for additional contraindications.

Sleep apnea may also occur as a primary diagnosis or be caused or exacerbated by opioid and hypnotic use. In complex cases, experienced nurse case managers may be required to assist in return to work. Several other staff members are involved, including a unit supervisor (DPT), coordinator (PhD, CCC-SLP), and editor.The external task force used to write recommendations included the following representatives: chiropractor, claimant's attorney (x2, one as alternate), doctor of osteopathic medicine, neurologist, nurse case manager, occupational medicine physician, occupational therapist, pain management physician (x2, one as alternate), pharmacist, physical medicine and rehabilitation physician (x3, one as a spinal cord stimulator specialist), physical therapist, psychologist, psychiatrist, and risk manager.There was also an external advisory panel used to review the proposed guideline. Treatment modalities may be utilized sequentially or concomitantly depending on chronicity and complexity of the problem, and treatment plans should always be based on a diagnosis utilizing appropriate diagnostic procedures.Before initiation of any therapeutic procedure, the authorized treating physician, employer and insurer must consider these important issues in the care of the injured worker:Acupuncture is recommended for subacute or chronic pain patients who are trying to increase function and/or decrease medication usage and have an expressed interest in this modality. RCTs that compared an intervention with not using that intervention (e.g., surgery and non-operative treatment) were designated as more relevant to workers' compensation guidelines than those RCTs which compared variations on technique or types of devices. A patient should have met the criteria in the opioids section of this guideline before beginning maintenance opioids. Stress-related psycho-physiological reactions may arise as a reaction to organic pain and in some cases may cause pain. Dermatologic. On occasion they are used for treatment in chronic pain or CRPS. Your Email: It should be noted that one article may be graded at different levels for different interventions. Prolonged immobility results in a wide range of deleterious effects, such as a reduction in aerobic capacity and conditioning, loss of muscle strength and flexibility, increased segmental stiffness, promotion of bone demineralization, impaired disc nutrition, and the facilitation of the illness role.Some level of immobility may occasionally be appropriate which could include splinting/casting or as part of a structured schedule that includes energy conservation or intentional rest breaks between activities. Unpublished articles or office handouts submitted by Task Force members or the public are reviewed and critiqued by the medical director, research methodologist and epidemiologist, who then communicate directly with the submitting individual regarding quality and relevance. A prolonged time off work is likely to lead to chronic disability. Activity should be increased based on the improvement of core strengthening.Patients should be educated to the detrimental effects of immobility versus the efficacious use of limited rest periods. Your Name: (optional)

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