Regional Pain Syndrome Case Summary

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DOI: 2/6/1981. This is a case of a 56-year old female nurse aide who sustained a work-related injury to her left shoulder when she tried catching a falling patient. As per OMNI entry, she was initially diagnosed with left shoulder dislocation. Pain pump was previously implanted and was subsequently removed in 09/2009.
Per progress report dated 8/15/2016, patient was diagnosed with complex regional pain syndrome.

Based on the progress report dated 09/12/16, the patient presents for management of neuropathic pain related to her left proximal humeral fracture and subsequent to seven or so operations required to stabilize the shoulder. The patient went for a five-year period prior to this visit with the nonunion of her fracture completely unstable, and we documented with nerve conduction studies that the patient had as much as 40% injury to all three main nerve trunks in her left upper extremity at the mid to proximal humeral level. The IW has a spinal cord stimulator, which provided rescue from extreme bursts of pain that were completely intolerable and at times left the patient not only screaming and yelling but also psychotic. The patient had an admission for schizophrenia that we think was very much induced by her central pain phenomenon to the point where this patient could utter nothing but word salad. She has done better since she was placed on Zyprexa. …show more content…
The patient had her arm stabilized by Dr. Itamura just prior to that, and it required staged procedures with an antibiotic placed spacer insertion prior to the patient's final reverse BioMet prosthesis in March 2013. The surgical sympathectomy had been done back in the 2000's and had not been effective. The patient has always had left hemibody pain worse than right, and she has complained of episodes of severe vaginal pain as

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