Acta Scientific Orthopaedics (ASOR)(ISSN: 2581-8635)

Case Series Volume 4 Issue 8

Pincer Grasp Pain- A New Sign in CRPS-1: A Case Series

Prakash Deshmukh1*, Helee Khetan2, Manjiri Ranade3 and Kailash Kothari4

1D. Anaesthesiology, Spine and Pain Management Centre, Kalyan West, Pain Clinic of India, Kalyan, Mumbai, Maharashtra, India
2Fellow, Pain Clinic of India, Chembur, Mumbai, Maharashtra, India
3D. Anaesthesiology, Pain Clinic of India, Thane, Mumbai, Maharashtra, India
4Director, Pain Clinic of India, Chembur, Mumbai, Maharashtra, India

*Corresponding Author:Prakash Deshmukh, D. Anaesthesiology, Spine and Pain Management Centre, Kalyan West, Pain Clinic of India, Kalyan, Mumbai, Maharashtra, India.

Received: July 03, 2021; Published: July 12, 2021


Background and Aims: Chronic regional pain syndrome (CRPS) has always been a diagnosis of exclusion. As there are no specific tests to confirm the diagnosis of CRPS, other causes of chronic pain such as nerve root compression, discopathy, muscular causes have to be definitively ruled out. This can cause a significant delay in the treatment of such patients who then have to suffer through the pain for a longer duration of time. During our practice, we have encountered several patients with confirmed CRPS of the upper limb who have all shown a common ‘sign’ which resolves upon treating the CRPS. This case series aims to describe the findings of these patients and also to provide a hypothesis for the mechanism behind the sign.

Methods: 4 patients who were diagnosed with CRPS of the upper limb were asked to perform the clinical test. The test involved pinching a piece of paper between their forefinger and thumb (pincer grasp, or OK sign) of the affected limb, and the end point was pain around the shoulder joint of the same limb. The test was repeated on the normal side with no elicitation of pain. The patients underwent T2-T3 sympathetic block with immediate relief of symptoms. They were asked to repeat the test on the affected limb after the procedure.

Result: All patients reported an immediate relief in their symptoms after the procedure. On repeating the pincer-grasp on the affected limb, there was no pain around the shoulder.

Conclusion: The pincer-grasp pain reflex looks to be a promising sign that may help in diagnosing CRPS, which may in turn reduce the time to treatment in these patients. Although more data has to be collected, preferably pooled, to document this sign in more patients, using this in clinical practice will be beneficial to patients. There need to be more studies to define it further.

Keywords: Complex Regional Pain Syndrome (CRPS); Pincer Grasp Pain


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Citation: Prakash Deshmukh., et al. “Pincer Grasp Pain- A New Sign in CRPS-1: A Case Series". Acta Scientific Orthopaedics 4.8 (2021): 19-25.


Copyright: © 2021 Prakash Deshmukh., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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