Turkish Journal of Physical Medicine and Rehabilitation 2008 , Vol 54 , Num 3

Painless Complex Regional Pain Syndrome: A Case Report

Banu Dilek 1 ,Özlem El 2 ,Ebru Şahin 3 ,Selmin Gülbahar 2 ,Çiğdem Bircan 4 ,Elif Akalın 2
1 Dicle Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Diyarbakır, Türkiye
2 Dokuz Eylül Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, İzmir, Türkiye
3 Dokuz Eylül Üniversitesi Tıp Fakültesi, Fizik Tedavi ve Rehabilitasyon Anabilim Dalı, İzmir, Türkiye
4 Dokuz Eylül Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, İzmir

A 57-years old female patient who had been treated by immobilization in a cast for six weeks after a distal radius fracture was evaluated for physical therapy and rehabilitation at the end of the immobilization period. She had complaints such as swelling, hyperhidrosis, and tremor in her affected hand and wrist, and restriction of finger and wrist movements. She had no pain. On examination, the hand and wrist were swollen and hot; range of motion was restricted at the wrist and fingers. Hyperhidrosis and tremor were also determined. There was no allodynia and hyperalgesia. The patient was diagnosed as complex regional pain syndrome Type I according to Zyluk scoring system. The patient’s signs and symptoms markedly improved after the physical therapy program and she did not report any pain at the control visits. This case is presented since she had no pain although she had marked vasomotor, sudomotor, and motor signs and sypmtoms which are typical for complex regional pain syndrome and few cases like this have been reported in the literature.

Keywords : Pain, complex regional pain syndrome, immobilizatio