Experiences of diagnosis and treatment for upper limb Complex Regional Pain Syndrome: a qualitative analysis

Pain Med. 2023 Dec 1;24(12):1355-1363. doi: 10.1093/pm/pnad111.

Abstract

Introduction: Complex Regional Pain Syndrome (CRPS) most frequently affects the upper limb, with high associated disability. Delays to diagnosis and appropriate treatment can adversely impact prognosis and quality of life, but little is known about the healthcare experiences of people with CRPS. This study aimed to explore lived experiences of diagnosis and treatment for people with upper limb CRPS.

Methods: Participants were recruited through online support groups and multiple public and private healthcare settings in the Greater Wellington Region, New Zealand. Semi-structured interviews were conducted with participants who had experienced upper limb CRPS for more than three months and less than three years. Interviews were transcribed verbatim and analysed using reflexive thematic analysis.

Results: Thirteen participants (11 female, 2 male) aged between 43 and 68 years were interviewed. Duration of CRPS ranged from 7 months to 2.5 years. Five themes were identified. Participants initially engaged in healthcare out of a desire to return to being the person they were before having CRPS. Three interacting experiences epitomised the overall healthcare experience: (1) not knowing what is going on, (2) not being taken seriously, and (3) healthcare as adding another layer of load. Meanwhile, participants used multiple approaches in an attempt to not let CRPS stop them from continuing to live their lives.

Conclusions: Participants in this study felt that credible information, validation, and simplification from healthcare providers and systems would support their process of navigating towards a meaningful life and self-concept in the presence of CRPS.

Keywords: Complex Regional Pain Syndrome; hand therapy; healthcare experience; rehabilitation; upper limb.

MeSH terms

  • Adult
  • Aged
  • Complex Regional Pain Syndromes* / complications
  • Complex Regional Pain Syndromes* / diagnosis
  • Complex Regional Pain Syndromes* / therapy
  • Disabled Persons*
  • Female
  • Health Personnel
  • Humans
  • Male
  • Middle Aged
  • Quality of Life
  • Upper Extremity