This website uses cookies to give you the best experience. By continuing to use this website you are consenting to cookies being used. You can delete and block cookies from within your browsers settings. For more information please refer to our privacy and cookie policy page.

Continue

Idiopathic pain syndromes

Chronic idiopathic pain syndromes or Chronic Regional Pain Syndromes (CRPS) are mostly seen in older female children and adolescents; the pain can be incapacitating but the patient is otherwise well, and physical examination is usually normal.

Chronic idiopathic pain syndromes can be widespread or localized.

The widespread type may associate with fatigue and debility. The localised type most commonly affects the foot or hand, may be triggered by trauma (often mild) and can have characteristic features of the affected part being cool, cyanosed and very sensitive to touch (like reflex sympathetic dystrophy) - it is important to exclude vascular ischaemia. These children are often very debilitated and are missing school.

Management is multidisciplinary involving physiotherapy, pain management and psychology support. Outcome is variable.

It is important to exclude differential diagnoses including inflammatory / rheumatic disease, metabolic and endocrine disease, infection and malignancy. Careful clinical assessment is important.

Investigations to consider include:

  • Full [complete] blood count (and film / peripheral smear) to help exclude malignancy or sepsis.
  • Acute phase reactants (ESR, CRP, ferritin).
  • Vitamin D and bone chemistry (consider rickets).
  • Muscle enzymes (consider muscle disease).
  • Thyroid function tests (consider hypothyroidism).

 With localised forms of CRPS, bone scan may show diffuse asymmetrical blood flow.

Site Statistics

To date (end of November 2018) pmm has >392,000 hits and >146,000 users from 205 countries!

Why register?

Some parts of pmm which involve pictures or videos of children, can only be viewed by registered users. Registering also allows you to bookmark favourite pages and track your viewing.

find out more

Short online courses

from Newcastle University, UK

e-resources from PMM

pmm for you

Please help us ensure pmm is as useful to you as possible by completing this short survey

complete survey