Case Study: Complex Regional Pain Disorder Student’s Name

Case Study: Complex Regional Pain Disorder Student’s Name

Case Study: Complex regional pain disorder

Complex regional pain disorder is a condition that culminates in pain, swelling, and

changes in the skin temperature, color, and texture among other symptoms (Urits et al.,

2018). Although it may also affect other body parts, it mostly affects the leg, arm, arm, foot,

or hand. The following case study analyzes a 43-year-old white male who presents with a

chief complaint of pain. He reports that his doctor referred him for psychiatric assessment

after asserting that the pain was “all in his head”. After comprehensive assessment and review

of information, the patient was diagnosed with complex regional pain disorder

Decision Step 1

The first decision I would make is to start the patient on Amitriptyline (Elavil) 25mg

QHS and titrate upward weekly by 25mg to a maximum dose of 200 mg per day. Originally

manufactured to treat depression and anxiety, Amitriptyline is a tricyclic depressant that

operates by deactivating beta-adrenergic receptors and serotonin 1A by enhancing

norepinephrine and serotonin neurotransmitters (Komoly, 2019). Therefore, the medication is

effective in lowering pain signals to the brain, reducing pain levels experienced, and

improving indulgence in activities of daily living for individuals suffering from chronic pain,

neuropathic pain, fibromyalgia, and other common pain syndromes (Komoly, 2019).

Although Savella is an SNRI, effective in the treatment of depression and fibromyalgia, it

may not be recommended for chronic hip pain (focused pain) (Urits et al., 2018). Therefore,

Savella was not selected for initiating treatment. Neurontin is one of the common medications

for the treatment of neuropathic and postherpetic pain (Stahl, 2013). Nonetheless, the efficacy

of Neurontin in the management of hip pain is not clearly documented (Stahl, 2013). The

treatment goal during the first decision step is to manage the presenting hip pain and relieve

other current symptoms