SHM Converge Scientific Abstract ePoster Gallery-The Diagnostic and Clinical Challenges of a Unique Case of Complex Regional Pain Syndrome Secondary to Massage Gun Use

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This case report describes a 21-year-old woman with severe bilateral foot pain, allodynia, and hyperalgesia after a hiking trip in Arizona during which she used a massage gun on her feet. Despite outpatient treatment with steroids, NSAIDs, gabapentin, and topical diclofenac, her pain worsened and was only temporarily relieved by prolonged cold-water foot baths, leading to hospitalization.<br /><br />Her inpatient evaluation was extensive and included consultations from infectious disease, neurology, general surgery, and physical medicine/rehabilitation. A broad differential diagnosis was considered, including atypical reactive arthritis, cold water submersion injury, small-fiber neuropathy, erythromelalgia, functional disorder, and CRPS. Extensive rheumatologic, infectious, metabolic, and imaging workup was largely unremarkable.<br /><br />As suspicion for CRPS increased, she was found to meet the Budapest Diagnostic Criteria, which require disproportionate pain, symptoms and signs in multiple categories, and no better alternative diagnosis. After confirmation, she entered a multidisciplinary inpatient rehabilitation program. Because standard medical therapy provided insufficient relief, she ultimately required interventional pain procedures, including popliteal nerve blocks and a lumbar sympathetic chain block with ablation, which produced lasting pain control.<br /><br />The report emphasizes that CRPS can be triggered by seemingly minor stimuli, making diagnosis difficult without a high index of suspicion. It also notes that CRPS in younger patients often occurs with minimal trauma and is associated with female sex, lower-extremity involvement, and psychosocial stressors such as anxiety and depression. Early multidisciplinary treatment is highlighted as beneficial, and sympathetic blocks may be considered when conservative therapies fail.

Asset Subtitle

Mitchell Sarkisov

Meta Tag

Author List Jeremy J. Gentile, Mitchell Sarkisov, Nicholas Parliament

Category Clinical Vignettes

Concept Complex Regional Pain Syndrome

Concept Budapest Criteria

Concept Disproportionate Pain

Concept Multidisciplinary Rehabilitation

Concept Minor Trauma

Distinguished Non-Finalist

Presenter Organization Corewell Health - Grand Rapids / MSUCHM

Presenting Author Mitchell Sarkisov

Track Adult

Keywords

complex regional pain syndrome

CRPS

allodynia

hyperalgesia

foot pain

sympathetic block

Budapest criteria

multidisciplinary rehabilitation

nerve block

lower extremity pain

Complex Regional Pain Syndrome

Budapest Criteria

Disproportionate Pain

Multidisciplinary Rehabilitation

Minor Trauma