Presentation
The system resulted from a special consensus conference that was convened on this topic and is based upon the patient's history, presenting symptoms, and findings at the time of diagnosis. [doi.org]
Case presentation We report the case of a 67-year-old woman who presented with shoulder-hand syndrome as the initial manifestation of gastric cancer which had metastasized to bone. [jmedicalcasereports.biomedcentral.com]
The central role of the sympathetic nerve is presently in doubt. [ncbi.nlm.nih.gov]
Entire Body System
- Rigor
However, considering the relatively low quality of available evidence, further rigorously designed and large-scale randomized controlled trials are needed to confirm the results. [ncbi.nlm.nih.gov]
Peer Review All articles undergo a rigorous, double-blind peer review, conducted by at least two independent experts in the field to ensure articles are balanced, objective, and relevant to the current clinical landscape. [touchoncology.com]
“In the four years I was under treatment through workers’ compensation insurance, which adhered to ‘fail first’ policies rigorously, more damage than healing occurred,” says Radene. [invisibleproject.org]
The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations. 9. [doi.org]
- Arm Pain
By the next day the pain had spread to involve her right arm. When she arrived at the hospital she described severe pain in both shoulders, spreading down the anterior aspect of her arms as far as her elbows. [ispub.com]
Skin
- Sweating
(3) a loss of CGRP expression on remaining innervation to vasculature and sweat glands; (4) an inappropriate expression of NPY on innervation to superficial arterioles and sweat glands; and (5) a loss of vascular endothelial integrity and extraordinary [dx.doi.org]
The sympathetic nervous system was examined by measuring skin temperature (infra-red thermography), testing different sympathetic vasoconstrictor reflexes (laser–Doppler flowmetry) and quantitative sudometry after thermal load (thermoregulatory sweat [doi.org]
The former term is preferable, however, because in many patients with reflex sympathetic dystrophy the distinguishing features are not pain but other manifestations of sympathetic stimulation, namely, rubor, pallor, or both, swelling, sweating and often [annals.org]
Other potential testing may include MRI, which may demonstrate bone marrow edema and autonomic testing of sweat output. [acepnow.com]
- Increased Sweating
Increased sweating (sudomotor changes) or increased chilling of the skin with goose flesh (pilomotor changes) 9. 3.SWELLINGa.Localised, initially pitting and later Brawnyb.Edema may be sharply demarcated along a line on the skin surface.* 10. 4.MOVEMENT [slideshare.net]
During this stage the symptoms include pain (usually described as a burning pain, which can be severe) and swelling, increased warmth in the affected part/limb, and excessive sweating. [davidlnelson.md]
Increased sweating (sudomotor changes) or increased chilling of the skin with goose flesh (pilomotor changes). Swelling: Localised, initially pitting and later Brawnyb.Edema may be sharply demarcated along a line on the skin surface. [mobilephysiotherapyclinic.in]
Some may experience hyperhydrosis (increased sweating). In mild cases this stage lasts a few weeks, in which it can subside spontaneously or respond rapidly to treatment (physical therapy, pain specialist). [en.wikipedia.org]
Increased sweating (hyperhydrosis). In mild cases this stage lasts a few weeks, then subsides spontaneously or responds rapidly to treatment. [web.archive.org]
Musculoskeletal
- Shoulder Pain
You are here Home » Tag: shoulder hand syndrome Hemiplegic Shoulder Pain & Complex Regional Pain Syndrome Evidence Review This review provides a complete discussion of the current literature on hemiplegic shoulder pain and complex regional pain syndrome [ebrsr.com]
shoulder-hand syndrome a disorder of the upper limb characterized by pain and stiffness in the shoulder, with puffy swelling and pain in the ipsilateral hand; it sometimes occurs after myocardial infarction but can also be produced by other causes. complex [medical-dictionary.thefreedictionary.com]
[…] with cervical spinal cord injury, focusing on the clinical features of SHS: shoulder pain, hand/wrist pain, edema, vasomotor changes, trophic changes and osteoporosis on x-ray. [ncbi.nlm.nih.gov]
In comparing groups of patients with and without shoulder pain in a rehabilitation facility, those without shoulder pain were significantly more likely to be functionally independent [ 72 ]. [karger.com]
- Frozen Shoulder
The pathogenesis of this dystrophy is unclear but entrapment of vessels and nerves in the frozen shoulder may pay a role. The shoulder capsulitis is treated by physical therapy aimed at avoiding immobility and strain of the shoulder. [diapedia.org]
Frozen Shoulder is seen five times more often among people who have diabetes than among people who do not. THREE STAGES OF FROZEN SHOULDER: Stage one: The affected shoulder begins to ache and feel stiff before becoming increasingly painful. [diabetesdigest.com]
Journal of Medical Case Reports, Jul 2008 Introduction Shoulder-hand syndrome is a relatively rare clinical entity classified as a complex regional pain syndrome type 1 and consisting essentially of a painful 'frozen shoulder' with disability, swelling [paperity.org]
SHS consists essentially of a painful 'frozen shoulder' with disability, swelling, vasomotor or dystrophic changes in the homolateral hand. The shoulder involvement usually precedes, sometimes accompanies or rarely follows the changes in the hand. [jmedicalcasereports.biomedcentral.com]
- Muscle Spasm
It may undergo skin and nail changes as well as muscle spasms and tightening. Once these changes occur, the condition is often irreversible. [mayoclinic.org]
Stage 1 (lasts 1 to 3 months): Changes in skin temperature, switching between warm or cold Faster growth of nails and hair Muscle spasms and joint pain Severe burning, aching pain that worsens with the slightest touch or breeze Skin that slowly becomes [nlm.nih.gov]
spasms; muscle loss (atrophy); tremors; dystonia; allodynia; hyperalgesia; decreased/restricted ability and painful movement of affected body part. [en.wikipedia.org]
There may be diffuse tenderness or point-tender spots in the muscles of the affected region due to small muscle spasms called muscle trigger points (myofascial pain syndrome). [web.archive.org]
- Muscular Atrophy
However, incidentally the capsulitis is complicated by shoulder-hand syndrome, a reflex dystrophy of the arm and hand which is accompanied by pain, muscular atrophy and sometimes by contractures of the hand. [diapedia.org]
atrophy (guttering) with contractures of the joints (osteoporosis may become evident with x-ray). [mobilephysiotherapyclinic.in]
- Muscle Spasticity
Nociceptive pain may be produced by the abnormal loading on muscles and ligaments caused by spasticity [ 7 ]. Spasticity can cause changes in rheologic muscle properties, leading to fibrosis, and atrophy [ 56 ]. [karger.com]
Neurologic
- Confusion
(The classification of neuropathic pain involving sympathetic effects is variable and confusing. But the term "complex regional pain syndrome" is the most common term that refers to the whole set of these types of pain syndromes.) [courses.washington.edu]
The confusing nature of the condition and it causes as well as its variable presentation often leads to a delayed diagnosis. It is not easy to either diagnose or treat. [davidlnelson.md]
It also adds to the confusion, frustration, anxiety and depression of the patient, which may intensify the patient's pain and adversely effect the doctor-patient relationship. [web.archive.org]
Despite this clinical distinction, core diagnostic features are identical across both subtypes, which adds to the confusion about the role of neuropathic mechanisms. [bmj.com]
- Dizziness
In patient 4, the S(+)-ketamine dosage had to be titrated more slowly due to dizziness during the initial three treatment days. This resulted in a reduced maximal S(+)-ketamine dose of 300 mg/day in this patient. [doi.org]
All drugs or combination of drugs can have various side effects such as drowsiness, dizziness, increased heartbeat, and impaired memory. Inform a healthcare professional of any changes once drug therapy begins. Sympathetic nerve block. [ninds.nih.gov]
- Ataxia
2800) RR 3.2 (95% CI 2.5 to 4.2), NNH 9.2 (95% CI 7.7 to 12); dizziness (16 studies, n = 3150) RR 3.2 (95% CI 2.5 to 4.2), NNH 7 (95% CI 6.1 to 8.4); peripheral oedema (nine studies, n = 2402) RR 3.4 (95% CI 2.1 to 5.3), NNH 19 (95% CI 14 to 29); and ataxia [doi.org]
- Hyperesthesia
Other sensations—eg, hyperesthesia, hyperalgesia, allodynia (pain due to a nonnoxious stimulus), and hyperpathia (particularly unpleasant, exaggerated pain response)—may also occur. [merckmanuals.com]
Treatment
The full syndrome recurred in six patients, all of whom responded to a second course of treatment. [ncbi.nlm.nih.gov]
Pain Management Center A program that includes treatment options for patients with RSD, trigeminal neuralgia and chronic pain. A look at the center itself as well as the specific treatments offered. [curlie.org]
Wilfrid Jänig and Ralf Baron, Mechanisms and Treatment Strategy of Complex Regional Pain Syndromes, Targeted Treatment of the Rheumatic Diseases, 10.1016/B978-1-4160-9993-2.00027-8, (370-385), (2010). [doi.org]
Prognosis
Recovery after CRPS treatment varies The prognosis for CRPS type I is better than that of CRPS type II When the syndrome continues for more than 1 year, it is likely that residual impairment will be present Regardless of the treatment afforded, patients [orthopaedicsone.com]
From What is the prognosis for reflex sympathetic dystrophy (RSD) The prognosis (outlook) and response to treatment in patients with RSD is unpredictable. [medicinenet.com]
However, if diagnosed early and treated aggressively, prognosis is improved. [patient.info]
Prognosis Each patient with CRPS responds differently to treatment. Spontaneous improvement occurs in some people. Others may have long-term changes despite treatment. [assh.org]
Etiology
Hand-Shoulder Syndrome Pain, swelling and osteoporosis Atrophy of the skin of the hand Etiology not known Reflex circulatory disturbance Seen secondary to Myocardial infraction Stroke Trauma Imaging Shoulder x-rays are usually negative Hand shows osteoporosis [learningradiology.com]
In this group belongs the idiopathic shoulder-hand syndrome. 33 It is becoming increasingly apparent that, although the etiology of these various syndromes may be different, many of their FULL TEXT [annals.org]
Autoimmune etiology of complex regional pain syndrome (M. Sudeck). Neurology. 2004 Nov 9. 63(9):1734-6. [Medline]. Oaklander AL, Fields HL. Is reflex sympathetic dystrophy/complex regional pain syndrome type I a small-fiber neuropathy?. [emedicine.medscape.com]
ETIOLOGY: Trauma (often minor). Ischemic heart disease and myocardial infarction. Spinal cord disorder. Cerebral lesions. Infections. Surgery. SIGN AND SYMPTOMS: Due to different causes, clinical manifestations. [mobilephysiotherapyclinic.in]
Epidemiology
Read more Within TREND 5 research programmes can be discerned: Epidemiology, Assessment technology, Trials, Genetics, and Biomarkers. Within each research programme multiple research projects are performed. [web.archive.org]
The capsulitis results in a 'frozen shoulder' with movement limitation in all directions, Epidemiology Shouder capsulitis occurs in 10% of patients with type 1 diabetes, in 25% of patients with type 2 diabetes and in 2% of the general population. [diapedia.org]
Valley Royal Hospital, Larbert, Stirlingshire, UK Correspondence to Dr Ishaq Abu-Arafeh, Department of Paediatrics, Forth Valley Royal Hospital, Larbert, Stirlingshire FK5 4WR, UK; iabu-arafeh{at}nhs.net Abstract Objective To study the clinical and epidemiological [doi.org]
All Mayo Clinic and Olmsted Medical Group medical records with codes for reflex sympathetic dystrophy (RSD), CRPS, and compatible diagnoses in the period 1989–1999 were reviewed as part of the Rochester Epidemiology Project. [dx.doi.org]
Pathophysiology
We conclude that a SHS complicating CSCI is associated with increased amplitude of the SSR, supporting the theory that sympathetic hyperactivity is important in the pathophysiology of reflex sympathetic dystrophy in this setting. [ncbi.nlm.nih.gov]
Pain. 93(2):165–171, AUG 2001 DOI: 10.1016/S0304-3959(01)00309-8, PMID: 11427328 Issn Print: 0304-3959 Publication Date: 2001/08/01 Checking for direct PDF access through Ovid Abstract In order to analyze the pathophysiology behind the clinical similarity [doi.org]
PMID: 15621369 Issn Print: 0304-3959 Publication Date: 2005/01/01 Checking for direct PDF access through Ovid Abstract Functional alterations in noxious, sensory and motor circuits within the central nervous system may play an important role in the pathophysiology [dx.doi.org]
Prevention
Some studies recommend the use of vitamin C to prevent complex regional pain syndrome. The objective of this meta-analysis was to evaluate the efficacy of vitamin C in prevention of CRPS. [doi.org]
Swelling and contracture of the hands continued to develop despite oral corticosteroid therapy, and one patient underwent surgery in an attempt to prevent the development of further deformity. [ncbi.nlm.nih.gov]
Some cases of CRPS type 1 may be preventable. [jfponline.com]