Background & Aims

Clinical practice guidelines on the management of Complex Regional Pain Syndrome (CRPS) recommend interdisciplinary care which includes both. pharmacological and non-pharmacological treatment such as Physical and Occupational therapy (1-3). However, little is known about the role that chiropractors may play in the interdisciplinary management of CRPS. Our overarching research objective is to better understand how chiropractors and persons with CRPS perceive each other and the potential for chiropractic care in CRPS. The primary aim of our study is: What are the beliefs, attitudes, and perceptions of persons with Complex Regional Pain Syndrome regarding chiropractic care?

Methods

Story completion is a relatively novel method enabling an investigation of social discourses in which writers (participants) are asked to reflect about and describe their experiences in order to gather insights into individual perceptions, beliefs, experiences and intention (4, 5). In story completion, participants are usually given a stem (one or few sentences) introducing a scenario and setting the stage for participants to then continue the story in their response (4). A secure online survey platform to conduct a cross-sectional story completion study with participants was used to collect this data. Participants living with CRPS were asked to write a short story based on 1 of 3 scenarios (persons living with CRPS for 1 month, 1 year or 5 years) to elicit beliefs, attitudes, and perceptions towards chiropractic care.

Results

Our preliminary results include thirty-five completed online surveys and stories. Thematic analysis was used to analyze the qualitative story completion data (6). Various thematic elements were found from participant’s responses. Stories of fear and anxiety as to what chiropractic care consists of were present. Other stories included thematic elements of hope that chiropractic was able to help in managing CRPS symptoms. Whereas, other responses presented themes of distrust and a negativity towards chiropractic care. Themes of chiropractic care being part of an interdisciplinary team were also found within the stories. Participants frequently wrote stories about how they did an immense amount of research online first before going to see a chiropractor.

Conclusions

Overall, the perception of chiropractic care by persons living with CRPS were mixed throughout the various themes that were explored in this study. Themes of fear, anxiety, distrust, and hope were explored. Our sample group of participants living with CRPS indicated that there is a hesitancy and reluctancy to explore chiropractic care for those living with CRPS. Participant’s view of chiropractic care may be skewed by what is available on the internet as there was a consistent theme that participants would look up what to expect from chiropractic care online before seeing a chiropractor for the first time. However there were also positive themes of hope that were present in participant’s stories in that chiropractic care could be helpful in managing symptoms of CRPS and that chiropractic care was expected to be part of a larger interdisciplinary team.

References

1. Harden, R. N., Oaklander, A. L., Burton, A. W., Perez, R. S. G. M., Richardson, K., Swan, M., Bruehl, S. (2013). Complex Regional Pain Syndrome: Practical Diagnostic and Treatment Guidelines, 4th Edition. Pain Medicine, 14(2), 180–229. doi:10.1111/pme.12033

2. Norman Harden, R., Swan, M., King, A., Costa, B., & Barthel, J. (2006). Treatment of Complex Regional Pain Syndrome. The Clinical Journal of Pain, 22(5), 420–424. doi:10.1097/01.ajp.0000194280.74379.48

3. Stanton-Hicks, M. D., Burton, A. W., Bruehl, S. P., Carr, D. B., Harden, R. N., Hassenbusch, S. J., Rezai, A. R. (2002). An Updated Interdisciplinary Clinical Pathway for CRPS: Report of an Expert Panel. Pain Practice, 2(1), 1–16. doi:10.1046/j.1533-2500.2002.02009.x

4. Gravett K. Story Completion?: Storying as a Method of Meaning-Making and Discursive Discovery. 2019;18:1–8.

5. Braun V, Clarke V. An Introduction to the Vignette Method. In: Successful Qualitative Research. Thousand Oaks, California: SAGE Publications Inc.; 2013.

6. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.

Presenting Author

Tara Packham

Poster Authors

Derick Luu

DC, MSc Candidate

McMaster University

Lead Author

Tara Packham

McMaster University

Lead Author

Topics

  • Specific Pain Conditions/Pain in Specific Populations: Complex Regional Pain Syndrome (CRPS)