Chiropractic Care of a Patient With Complex Regional Pain Syndrome Type 1 (CRPS-1): A Case Report

Objective: The purpose of this case report is to describe the evaluation and treatment of a patient presenting with left upper extremity pain and neck pain after a slip and fall. Clinical Features: A 56-year-old woman sustained a left distal radius fracture secondary to a slip-and-fall accident. She was placed in a cast for 6 weeks, and after the removal of her cast she developed excruciating left forearm, wrist, hand, and finger pain. The patient was diagnosed with complex regional pain syndrome type 1 utilizing the modified (Budapest) International Association for the Study of Pain criteria. Intervention and Outcome: The patient did not respond positively to initial management, which included the application of a cast after closed reduction of the distal radius fracture, 8 weeks of physical/occupational therapy, and the use of a brace which kept her left wrist, hand, and fingers in a flexed position. Subsequently, the patient presented to the University of Bridgeport College of Chiropractic outpatient clinic, where she was evaluated and treated. She received a total of 36 chiropractic treatments between her initial office visit in January 2018 and the follow-up in June 2018. The patient reported and demonstrated amelioration of her presenting complaints, decreased pain, increased ranges of motion, and increased function. Conclusion: This case report underscores the importance of a rapid, accurate, initial diagnosis of complex regional pain syndrome type 1, during the acute (warm) stage.