Complex regional pain syndrome

On my paediatric placement I had an 11 year old patient with complex regional pain syndrome! I didn't realise children could have this syndrome. This patient presented with excruciating pain in her calves. The patient couldn't extend her knees past 30 degrees of flexion and refused to walk on her heels. During the assessment the patient cried during active knee extension.

I became quite frustrated with this patient, however managed to hide it inside. It is difficult to understand the pain this patient was feeling as the pain is real to her. On assessment the patient couldn't actively extend past 30 degrees flexion however when the patient was distracted she extended her knees to 15 degrees flexion.

I took the patient to the hydrotherapy pool for treatment with another child who had severe cerebral palsy. Seeing the contrast of these 2 patients was eye opening. The child with cerebral palsy (spastic quadriplegia) was swimming and walking for the first time in 3 years. She was trying so hard and loving the pool. The patient with chronic regional pain syndrome was in tears as the other physio was doing passive knee extension.

This experience definitely made me realise that I had started to judge patients. In the future I will avoid comparing patients and their response to pain, as everyone is different, has different backgrounds and expectations. Therefore I must treat each patient as an individual and provide them with optimal treatment.