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Final Program


Final Program

Pediatrics

826 - No Pain, All Gain: Multidisciplinary Approach to Pediatric Lower Extremity Complex Regional Pain Syndrome

Friday, February 20, 2026
5:00 PM - 6:30 PM AST

    Presenting Author(s)

  • LA

    Lucendia Adams, MD

    Resident Physician
    Indiana University School of Medicine
    Indianapolis, Indiana, United States

    • Co-Author(s)

  • JC

    Jessica Camilleri, DO

    Riley Hospital for Children Pediatric Inpatient Rehabilitation Medical Director
    Riley Hospital for Children
    Indianapolis, Indiana, United States

    • Submitter(s)

  • LA

    Lucendia Adams, MD

    Resident Physician
    Indiana University School of Medicine
    Indianapolis, Indiana, United States

Case Diagnosis: Complex Regional Pain Syndrome

Case Description: 11 year old female with 1 year of right foot pain w/o injury that led to inability to bear weight through the right lower extremity. After negative x-ray and MRI of the foot, she failed biweekly physical therapy, pharmacotherapy, and offloading with knee scooter, so was referred to PM&R for further evaluation. Exam revealed significant allodynia, limited range of motion of the ankle, and swelling. She was giving a diagnosis of Complex Regional Pain Syndrome and ultimately underwent epidural placement immediately followed by pediatric inpatient rehabilitation program to address functional deficits. She was followed by a physiatrist, pain management team, and pain psychiatry team. Upon discharge, she was ambulating 1580 ft in 6MWT and navigating 350 stairs with the epidural analgesia. She was to discharge home with epidural, but developed cellulitis around the epidural, so it was removed and required IV antibiotics and prolonged hospital stay.

Discussions: CRPS is an understudied diagnosis, especially pediatric PM&R. Not only is the pathophysiology behind the syndrome complex, multifaceted, and poorly understood, the treatment follows the same suit in complexity. The paucity of high quality research has shown that a multidisciplinary approach with elements of therapy, psychological interventions, pharmacologic tools, and interventional procedures is key in improving functional outcomes in CRPS patients. In this case, a pediatric dancer failed conservative measures, but after evaluation by a physiatrist, she was accepted into an inpatient pediatric rehab program after an epidural placement to focus on functional improvements while also being followed closely by pediatric pain management and pain psychology teams.

Conclusions: CRPS is a multifaceted and difficult to treat syndrome based on the paucity of high quality research, especially in the pediatric population. This case highlights a pediatric patient with improved functional gains after a multidisciplinary approach with inpatient rehab combined with epidural analgesia.