Occupational and Physical Therapy as a Treatment of CRPS/RSD
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About Your CRPS
For this survey, the most current name, CRPS, will be used. But please take it as if it were worded RSD, Causalgia, RND or one of the other synonyms for this syndrome.
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1
. When did your CRPS start (please give day, month, and year if possible, if exact date is not known, enter only year/month, or year).
When did your CRPS start (please give day, month, and year if possible, if exact date is not known, enter only year/month, or year).
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2
. How long was it from the initial onset of symptoms of CRPS and when you were diagnosed with CRPS?
How long was it from the initial onset of symptoms of CRPS and when you were diagnosed with CRPS?
Less than a month
1-3 months
3-6 months
6 months to 1 year
1-3 years
3+ years
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3
. How did your CRPS start?
How did your CRPS start?
Cut
Broken bone
Sprain/strain
Other injury, not directly to a nerve
Surgery
Nerve Damage
Other (please specify)
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4
. Where was the initial onset of CRPS?
Where was the initial onset of CRPS?
Head
Neck/Shoulders
Left Arm/Hand
Right Arm/Hand
Chest
Pelvic Area/Hips
Back
Left Leg/Foot
Right Leg/Foot
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