Assignment: Assessing and Treating Clients with Pain
Pain can greatly influence an individual’s quality of life, as uncontrolled pain negatively impacts mood, concentration, and the overall physical and mental well-being of clients. Although pain can often be controlled with medications, the process of assessing and treating clients can be challenging because pain is such a subjective experience. Only the person experiencing the pain truly knows the intensity of the pain and whether there is a need for medication therapies. Sometimes, beliefs about pain and treatments for pain can have an adverse effect on the provider-client relationship. For this Assignment, as you examine the interactive case study consider how you might assess and treat clients presenting with pain.
Learning Objectives
Students will:
• Assess client factors and history to develop personalized therapy plans for clients with pain
• Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring therapy for pain
• Evaluate efficacy of treatment plans for clients presenting for pain therapy
• Analyze ethical and legal implications related to prescribing therapy for clients with pain

To prepare for this Assignment:
• Review this week’s Learning Resources. Consider how to assess and treat clients requiring therapy for pain and sleep/wake disorders.
The Assignment
Examine Case Study: A Caucasian Man with Hip Pain. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
• Decision #1
o Which decision did you select?
o Why did you select this decision? Support your response with evidence and references to the Learning Resources.
o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
o Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?



• Decision #2
o Why did you select this decision? Support your response with evidence and references to the Learning Resources.
o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
o Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
• Decision #3
o Why did you select this decision? Support your response with evidence and references to the Learning Resources.
o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
o Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.

Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

Complex Regional Pain Disorder
White Male With Hip Pain

BACKGROUND
This week, a 43-year-old white male presents at the office with a chief complaint of pain. He is assisted in his ambulation with a set of crutches. At the beginning of the clinical interview, the client reports that his family doctor sent him for psychiatric assessment because the doctor felt that the pain was “all in his head.” He further reports that his physician believes he is just making stuff up to get “narcotics to get high.”
SUBJECTIVE
The client reports that his pain began about 7 years ago when he sustained a fall at work. He states that he landed on his right hip. Over the years, he has had numerous diagnostic tests done (x-rays, CT scans, and MRIs). He reports that about 4 years ago, it was discovered that the cartilage surrounding his right hip joint was 75% torn (from the 3 o’clock to 12 o’clock position). He reports that none of the surgeons he saw would operate because they felt him too young for a total hip replacement and believed that the tissue would repair with the passage of time. Since then, he reported development of a strange constellation of symptoms including cooling of the extremity (measured by electromyogram). He also reports that he experiences severe cramping of the extremity. He reports that one of the neurologists diagnosed him with complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy (RSD). However, the neurologist referred him back to his family doctor for treatment of this condition. He reports that his family doctor said “there is no such thing as RSD, it comes from depression” and this was what prompted the referral to psychiatry. He reports that one specialist he saw a few years ago suggested that he use a wheelchair, to which the client states “I said ‘no,’ there is no need for a wheelchair, I can beat this!”
The client reports that he used to be a machinist where he made “pretty good money.” He was engaged to be married, but his fiancé got “sick and tired of putting up with me and my pain, she thought I was just turning into a junkie.”
He reports that he does get “down in the dumps” from time to time when he sees how his life has turned out, but emphatically denies depression. He states “you can’t let yourself get depressed… you can drive yourself crazy if you do. I’m not really sure what’s wrong with me, but I know I can beat it.”
During the client interview, the client states “oh! It’s happening, let me show you!” this prompts him to stand with the assistance of the corner of your desk, he pulls off his shoe and shows you his right leg. His leg is turning purple from the knee down, and his foot is clearly in a visible cramp as the toes are curled inward and his foot looks like it is folding in on itself. “It will last about a minute or two, then it will let up” he reports. Sure enough, after about two minutes, the color begins to return and the cramping in the foot/toes appears to be releasing. The client states “if there is anything you can do to help me with this pain, I would really appreciate it.” He does report that his family doctor has been giving him hydrocodone, but he states that he uses is “sparingly” because he does not like the side effects of feeling “sleepy” and constipation. He also reports that the medication makes him “loopy” and doesn’t really do anything for the pain.
MENTAL STATUS EXAM
The client is alert, oriented to person, place, time, and event. He is dressed appropriately for the weather and time of year. He makes good eye contact. Speech is clear, coherent, goal directed, and spontaneous. His self-reported mood is euthymic. Affect consistent to self-reported mood and content of conversation. He denies visual/auditory hallucinations. No overt delusional or paranoid thought processes appreciated. Judgment, insight, and reality contact are all intact. He denies suicidal/homicidal ideation and is future oriented.
Diagnosis: Complex regional pain disorder (reflex sympathetic dystrophy)

Decision Point One
Select what the PMHNP should do:

Savella 12.5 mg orally once daily on day 1; followed by 12.5 mg BID on day 2 and 3; followed by 25 mg BID on days 4-7; followed by 50 mg BID thereafter Click to see options it will take you to decision point two and three

Amitriptyline 25 mg po QHS and titrate upward weekly by 25 mg to a max dose of 200 mg per day Click to see options it will take you to decision point two and three

Neurontin 300 mg po BEDTIME with weekly increases of 300 mg per day to a max of 2400 mg if needed Click to see options it will take you to decision point two and three

All references require creditable sources, nothing less than 5 years. References require doi or http. Please add conclusion.
Tips:
– Always use the choices given
– Continuation of psych meds may be needed before switching as they take time.
Staying the course (more time) or increasing for the second decision is a good choice
– A 61% reduction is within the proper response limits therefore not changing for the third decision is proper.
– Remember to not be quick to switch any psych meds as many take a long time to start working.

EXAMPLE ONE NOT TO BE USED WORD FOR WORD.

Introduction
Complex regional pain syndrome is a debilitating condition that affects the limbs and is likely to be induced by trauma or surgery. Apart from complicating the entire recovery process, it tends to impair the psychosocial and functional well-being of an individual. It’s characterized by vasomotor abnormalities, hyperalgesia, , and allodynia. The pain that a patient experiences is often disproportionate to the degree of tissue injury that occurs and may persist beyond the anticipated period required for tissue healing (Stanton-Hicks, 2018). The major goals of therapy are: to ensure pain relief, to restore functioning and psychologically stabilize a patient.
Many drugs are often used in pain management to improve functional status. However, mental health practitioners should ensure that the choice of drugs promotes compliance and have fewer side effects. This paper discusses the management of a 43-year-old who presented with complex regional pain disorder. In his management, three decisions are to be made regarding the most effective medications, expected outcomes, , and actual outcomes. A description of the ethical issues when engaging clients with complex regional pain disorder and their families will also be provided.
Decision #1
Decision Selected
Start Savella 12.5 mg orally once daily on day 1; followed by 12.5 mg BID on day 2 and 3; followed by 25 mg BID on days 4-7; followed by 50 mg BID thereafter
Reasons for Selecting This Decision
Patients with regional pain disorder have a low pain threshold which may be caused by changes in the central nervous system. These changes cause a patient to be more sensitive to pain due to wrong neurotransmitter levels in the brain. As selective norepinephrine and serotonin reuptake inhibitor (SNRI) that has an equal effect on both neurotransmitters, Savella is an NMDA antagonist that works on nerve endings to produce analgesic effects (Stanton-Hicks, 2018). It promotes the reuptake of the neurotransmitters in the brain thus easing the pain, reducing fatigue and promoting memory.
Amitriptyline, a tricyclic antidepressant that has proven to be effective in the management of neuropathic pain off label could also be a good option (Benzon, Liu & Buvanendran, 2016). However, it has a side effect of drowsiness and dizziness that the client initially stated clearly that he didn’t like. Therefore, prescribing this medication for a start might only trigger non-compliance.
Neurontin, also referred to as gabapentin, is an anti-epileptic / anticonvulsant, is used in for nerve pain relief. Therefore, it could also be a good option for the management of this patient. However, it also has the side effects of drowsiness and in high doses, results in extreme somnolence and drowsiness (Finnerup, et al., 2015). Since the patient expressed his dislike for the side effect of feeling sleepy from the start, prescribing it would only lead to non-compliance.
Expected Outcome
By starting the patient on Savella, it was expected that his pain will significantly reduce to 3 on a scale of 1-10 and be able to walk without support. It was also expected that he would resume to a normal work routine and be able to perform activities of daily life will very minimal or no assistance (Stanton-Hicks, 2018). His mood would be happy or joyous and he would have a stable effect.

Difference between Expected outcome and Actual Outcome
The client returned to the clinic after four weeks walking without crutches but minimally limping. He reported that the main was more manageable and he was able to walk around with no assistance. However, he noted that the pain was worse during the morning hours and got better as the day progressed. On a scale of 1-10, his pain was reportedly 4 but admitted that he could be able to live and tolerate a level of 3. The client also noted that he occasionally experienced bouts of sweating that he couldn’t explain with some sleep disturbance. An assessment revealed that he had a blood pressure of 147/92mmhg and a pulse of 110 beats/ min. He was still future-oriented and denied homicidal/suicidal ideation. One of the major side effects of Savella is heart palpitations (Finnerup, et al., 2015). It is for this reason that the patient experienced bouts of sweating, sleep disturbance and had a high blood pressure. Reducing the dosage can help to minimize this side effect.
Decision #2
Decision Selected
Continue With the Current medication but reduce the dosage to 25 mg twice daily
Reasons for Selecting This Decision
During the first visit, the client reported that he experienced unexplained symptoms of bouts of sweats, sleep disturbance and he had a high blood pressure. These symptoms were the resultant side effects of Savella. According to Stanton-Hicks (2018), by reducing the dosage of Savella, its side effects are also minimized resulting in more improved health outcomes.

Expected Outcome
By reducing the dosage of Savella, it was expected that the patient’spatient’s pain level will also be minimized, he will still be able to perform most activities of daily life with very minimal support and that his social, professional and physical functioning will also improve (Benzon, Liu & Buvanendran, 2016). Above all, the dosage reduction aimed to ensure that the side effects weren’t adverse and that he would live a near normal life.
Difference between Expected outcome and Actual Outcome
After four weeks, the patient returned to the clinic walking with crutches. He stated that the pain was 7 out of 10 and admitted that he didn’t feel good as compared to the previous month. He frequently woke up at night due to pain on his right leg and foot. He, however,, however, denied homicidal and suicidal ideation. His blood pressure was 124/85 and pulse rate was 87 beats/ min. He looked sad and discouraged by the slip in the management of his pain. The decision to lower the dosage of Savella in managing the client’s initial side effects to the dug inspired this difference at the cost of uncontrolled pain (Murnion, 2018).
Decision #3
Decision Selected
Change Savella to 25 mg orally in the morning and 50 mg orally at bedtime
Reasons for Selecting This Decision
During the client’s first visit to the clinic, he clearly stated that the medication Savella was effective for his pain management, but the pain worsened early morning and improved as the day progressed. As supported by Finnerup, et al., (2015), starting with dose reductions during parts of the day when pain is mostly under control is a good idea that can still contribute to the achievement of therapeutic goals.
Expected Outcome
It was expected that the patient’s pain will effectively be managed to a level of 3 on a scale of 1-10. He will also be able to walk and perform most of his activities of daily life with minimal or no support. As supported by Stanton-Hicks (2018), the patient would no longer experience sleep disturbance and that his affect and mood will gradually be stable. With regards to the drugs side effects, it was expected that the patient’s blood pressure and pulse rate will gradually normalize and that he will no longer experience palpitations or unexplained bouts of sweating.
Difference between Expected outcome and Actual Outcome
The client returned to the clinic after four weeks walking without crutches. He reported his pain level to be 4 on a scale of 1-10 and expressed how he was grateful but would love it to reduce to 3 since it’s the best level that he could easily manage. His blood pressure was 120/84mmhg and pulse rate 86beats/min. He denied suicidal/homicidal ideation and was still future-oriented. At this point, it will be necessary to explain to the client that he has a neuropathic pain syndrome which probably may never respond to pain medications. Therefore, it would be practical to collaboratively set realistic expectations and make the patient understand that he will frequently experience some pain level daily (Benzon, Liu & Buvanendran, 2016). What matters most is to manage it in such a manner that permits him to effectively perform activities of daily life. The patient should also be educated that medications are not a final solution but a part of a complex regimen of chiropractic care, physical therapy, massage and heat therapy (Murnion, 2018).
How Ethical Considerations Might Impact Treatment plan and Communication With Clients
The most significant ethical consideration for this client is that of informed consent, autonomy, beneficence, and non-maleficence. Before changing any treatments, it is important to seek informed consent just to ensure that he is fully aware of what he is consenting to, possible dangers and outcomes involved (Millum, 2013). Secondly, any treatment options considered should only be for the patient’s best interest/benefit and have fewer side effects. This will guarantee that all treatment options cause no harm. Lastly, the client’s autonomy should also be respected such that, he shouldn’t be forced or coerced to agree to a treatment modality that his conscience is against (Millum, 2013).
Conclusion
The management of regional pain disorder in adults requires a careful and thorough assessment of a patients needs which will help to decide the best medications to use as part of a broader regimen of heat and massage therapy, chiropractic care and physical therapy. Savella, an SNRI was the best medication choice for the management of this patient’s pain. It has minimal side effects with the major side effect being heart palpitations which can be managed with dosage reduction. Although in patients with regional pain disorder dose reduction comes with the cost of uncontrolled pain, string reductions during the parts of a day when pain is mostly under control helphelp to achieve the desired therapeutic goals as it was in this case.


– Free Essay Sample
Psychopharmacologic Approaches to Treatment of Psychopathology

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Psychopharmacologic Approaches to Treatment of Psychopathology
Introduction
Treatment of regional pain disorder requires various approaches. One of the best strategies is to prescribe Savella, a popular and effective drug. The current case study involves a patient with regional pain disorder which requires a psychopharmacological approach. According to the case study, the three decisions had a variety of outcomes, which informed subsequent decisions. The best decisions involve reducing or increasing the dosage depending on the patient outcomes (Ott & Maihöfner, 2018). The assessment also provides an outline of the ethical issues that affect treatment. Treatment and management of pain in patients suffering from regional pain disorder focus on improving the functional status to enable a patient to freely participate in daily activities.
Decision #1
The best decision among the three medications is to prescribe Savella 12.5 mg orally once daily on day 1; followed by 12.5 mg BID on day 2 and 3; followed by 25 mg BID on days 4-7; followed by 50 mg BID onwards.
The purpose of selecting the decision is to relieve the pain by reducing the sensitivity of the pain on the brain. Patients with regional pain disorder experience a low pain threshold (Azqueta‐Gavaldon et al., 2017). The low threshold is due to changes in the central nervous system. Notably, the impaired neurotransmitter levels in the brain makes patients of regional pain disorder sensitive to pain (Azqueta‐Gavaldon et al., 2017). Such patients require medication that will affect neurotransmitters. For example, norepinephrine and serotonin reuptake inhibitor (SNRI) are essential for treatment. Savella drug produces analgesic effects on the nerve endings (Borchers & Gershwin, 2017). The reuptake of neurotransmitters in the brain triggers various effects including relieving pain, fatigue and enhancing memory (Borchers & Gershwin, 2017). Therefore, the drug will be relevant and effective for the patient who has experienced pain for 7 years.
During the prescription of the drug, it is effective to educate the pain to avoid any drug or alcohol to avoid adverse side effects. For example, taking alcohol and Savella may lead to blackouts, fainting or even death (Bose & Banerjee, 2018). The patient should also stick to the treatment dosage according to the prescription.
Amitriptyline is also a popular antidepressant that is effective in the treatment and management of neuropathic pain. However, the drug causes side effects such as drowsiness which the patient disliked during the assessment (Bose & Banerjee, 2018). Prescribing Amitriptyline might trigger non-compliance which will lead to delay in recovery. On the other hand, Neurontin is another popular drug that is effective in nerve-pain relief. The drug is anticonvulsant and antiepileptic (Bose & Banerjee, 2018). The drug can, however, cause side effects that the current patient does not like. Drowsiness and dizziness are common side effects, which can increase if a patient takes high doses (Bose & Banerjee, 2018). To avoid non-compliance, it is crucial to avoid such drugs that the patient may dislike.
The expected outcomes of the treatment are to relieve the pain to 3 points on a scale of 1 to 10. For example, relieving pain should be evident when the client can walk without support (Miller et al., 2019). The patient should also resume participation in daily tasks and also minimal participation at the place of work. Participation should involve minimal or no support. The drug should also trigger a stable effect leading to a happy and joyous mood.
The patient returns to the clinic after four weeks. It is evident that the patient is walking without crutches or any help, but with minimal limping. He reports that the pain had subsided significantly enabling him to walk without any assistance. According to the patient, the pain was more severe in the morning compared to the evening. He rated the severity of the pain at 4 on a scale of 1 to 10. Additionally, he reported a lack of quality sleep and episodes of sweating. The outcomes are expected for patients taking Savella. The drug is known to cause an increase in heart palpitations. The changes in heart palpitations lead to episodes of sweating and sleep disturbance (Miller et al., 2019). For example, the patient had a blood pressure of 147/92mmhg and a pulse of 110 beats/ min. However, the patient denied any suicidal thoughts. One of the best decisions to reduce the side effects is to lower the dosage of the drug.
The outcomes and expected results had several similarities and differences. One of the similarities includes the ability to walk with minimal support. The outcome shows the patient is responding positively to the drug. However, it is essential to manage the side effects since they can undermine the quality of life of a patient.
Decision #2
The second decision is based on the outcomes of decision#1. According to the outcomes, the patient is responding positively to the drug. Therefore, it is essential to continue with the current drug since it has minimal side effects. However, due to the side effects, it is essential to reduce the dosage to Savella 25mg BID daily (Miller et al., 2019). One of the expected outcomes after reducing the dosage is to enhance the quality of sleep, lower the blood pressure, and reduce episodes of sweating. Evidence-based practice shows that minimizing the side effects is essential in boosting quality health outcomes.
It is not healthy to change the drug due to the side effects since several drugs to treat psychological disorders a certain level of side effects. Research also shows that changing the drug can trigger adverse effects in a patient thus undermining the quality of health (Ott & Maihöfner, 2018). The drug is also causing positive change according to the expectations. The patient should thus continue taking the medication for several weeks to realize full recovery (Ott & Maihöfner, 2018). Treatment will thus focus on balancing the side effects and relieving the symptoms.
The expectation is that the level of pain in the pain will reduce significantly. For example, the patient should participate in his workplace without any support. He should also carry out daily activities and walk without limping. He should also record an improvement in the physical functioning of body parts. Another expectation is linked to the reduction in the dosage. For example, the patient should not experience an increase in heart palpitations, sleep disturbance or episodes of sweating (Azqueta‐Gavaldon et al., 2017). A reduction of the side effects and pain will lead to an improvement in the quality of life of a patient.
The expectations and outcomes had some differences. After four weeks, the patient reported back to the clinic complaining of severe pain. He was also walking on clutches complaining that the severity of pain was at 7 out of 10. According to the patient, there was a significant difference between the previous month and the current month. He also reported that his sleep interfered with the severe pain at night which made him wake up in the middle of the night. The patient, however, denied suicidal or homicidal ideation. He also looked sad and discouraged by the negative results of pain management. According to the assessment, the patient had a blood pressure of 124/85 and a pulse rate of 87 beats/ min. He denies any heart palpitations.
One of the main reasons for the outcome is the reduction in the dosage of Savella. Research shows that a reduction in dosage can improve the side effects whereas interfering with pain management (Azqueta‐Gavaldon et al., 2017). The subsequent treatment of the condition should focus on increasing the dosage to reduce the severity of the pain.
Decision #3
Decision#3 has several options including changing the medication, reducing or increasing the current medication. The best decision is inspired by the outcomes of decision#2. One of the best decisions is to prescribe Savella 25mg orally in the morning and 50mg orally at bedtime. The purpose of increasing the dosage during bedtime is to reduce instances of waking up at night due to intense pain.
The decision to continue with the medication, despite the negative outcomes in the previous decision, is because it produced positive effects. For example, the patient walked without the use of crutches. Prescribing the drug in different dosages is focused on addressing the severity of the pain depending on when it worsens (Borchers & Gershwin, 2017). Research shows the approach is effective in pain management due to the ability to suppress the negative outcomes (Borchers & Gershwin, 2017).
The expectation of continuing with the current drug is that the severity of the pain will reduce to level 3 on a scale of 1 to 10. A reduction in the pain will enable the patient to participate in daily activities or walk without using crutches. The patient should also walk without limping. Another expected outcome is that the patient will not wake up at night due to pain. Additionally, the mood will gradually improve as the patient experiences the progress (Borchers & Gershwin, 2017). It is also anticipated that the blood pressure of the patient will normalize within the next four weeks. For example, he should not experience palpitations or episodes of sweating.
The outcomes of decision$3 demonstrate positive progress in the management of pain. After four weeks, the patient returned to the clinic walking without crutches. He reports that the severity of pain had improved to level 4 on a scale of 1 to 10. The patient, however, expressed interest to further reduce the pain to level 3 to help him cope up and carry out daily activities normally. According to the assessment, the patient had a blood pressure of 120/84mmhg and pulse rate 86beats/min. He was still future-oriented and with no cases of homicidal or suicidal ideation.
During the clinic, it is essential to educate the patient about the dynamics of the pain. The patient should know that neuropathic pain syndrome may cause long-term pain with minimal response to medication (Bose & Banerjee, 2018). The treatment plan should thus have realistic goals since the patient may need to cope up with some level of pain. The priority should be to manage the pain to a level that will enable the patient to carry out daily activities, walk without crutches and work (Bose & Banerjee, 2018). A clinician should also educate the patient that medication is part of a complex regimen to treat and manage pain. For example, the patient should embrace physical therapy, heat therapy and massage (Miller et al., 2019). The different approaches are necessary to manage pain to a level that can be sustained to help the patient live a normal life.
Ethical Issues Affecting Treatment
Ethical issues affect treatment and guide the communication between a patient and a clinician. One of the issues is the informed consent of a patient. Clinicians should seek informed consent of a patient before prescribing any medication (Conway & O’Connor, 2016). They should educate the patient to ensure they understand the implications and side effects. The second ethical issue is to make decisions in the best interest of a patient (Conway & O’Connor, 2016). For example, clinicians should uphold the ‘do no harm’ principle to ensure the offer quality treatment to all. It is essential to interview the patient to find out the impact of the drug for better decision making (Conway & O’Connor, 2016). The autonomy of a patient is also crucial. A patient should not be coerced or forced to take any medication without their approval.
Conclusion
Treatment and management of pain require critical decisions. Medications should also balance between the management and side effects. Savella is one of the best drugs to treat and manage pain. The case study involved a series of decisions that led to various outcomes. One of the best approaches is to weigh the outcomes and make the right choices. Ethical considerations such as informed consent also determine the quality of treatment.

References
Azqueta‐Gavaldon, M., Schulte‐Göcking, H., Storz, C., Azad, S., Reiners, A., Borsook, D., … & Kraft, E. (2017). Basal ganglia dysfunction in complex regional pain syndrome–A valid hypothesis? European Journal of Pain, 21(3), 415-424. https://doi.org/10.1002/ejp.975
Borchers, A. T., & Gershwin, M. E. (2017). The clinical relevance of complex regional pain syndrome type I: The Emperor’s New Clothes. Autoimmunity Reviews, 16(1), 22-33. https://doi.org/10.1016/j.autrev.2016.09.024
Bose, R., & Banerjee, A. D. (2018). Spinal cord stimulation for complex regional pain syndrome type I with spinal myoclonus–a case report and review of literature. British Journal of Neurosurgery, 1-3. https://doi.org/10.1080/02688697.2018.1552755
Conway, M., & O’Connor, D. (2016). Social media, big data, and mental health: current advances and ethical implications. Current Opinion in Psychology, 9, 77-82. https://doi.org/10.1016/j.copsyc.2016.01.004
Miller, C., Williams, M., Heine, P., Williamson, E., & O’connell, N. (2019). Current practice in the rehabilitation of complex regional pain syndrome: a survey of practitioners. Disability and Rehabilitation, 41(7), 847-853. https://doi.org/10.1080/09638288.2017.1407968
Ott, S., & Maihöfner, C. (2018). Signs and symptoms in 1,043 patients with complex regional pain syndrome. The Journal of Pain, 19(6), 599-611. https://doi.org/10.1016/j.jpain.2018.01.004

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