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CRPS is a devastating diagnosis at any age, but a young person with CRPS is particularly harrowing. Here, Young person with CRPS
CRPS is a devastating diagnosis at any age, but for a young person with CRPS, it’s a particularly bitter pill to swallow. Indeed, a study published in 2020 concluded:
“Most patients with childhood-onset complex regional pain syndrome continue to have some complex regional pain syndrome–related pain into young adulthood and have a lower health-related quality of life.”
In recent years, the youngest person with CRPS I’ve represented was just 15 years old when a car struck her with a glancing blow on a zebra crossing. Now an adult, Chloe (not her real name) has kindly allowed me to tell her story.
The accident
Chloe was walking to school when a vehicle clipped her lower right leg while she was on the crossing, causing her to fall over. The driver failed to stop. Although in pain, she scrambled to her feet and hobbled to school. However, as the day went on, her lower leg became increasingly painful, cold to the touch, and began turning blue.
On arriving home, Chloe’s Mum took her to Accident and Emergency, where an x-ray confirmed no fracture. A doctor reassured her and discharged her with advice to take paracetamol and ibuprofen.
Early progress
Instead of improving, her leg became more painful and kept changing colour. Returning to the hospital, the doctors admitted Chloe for observation for several days. A battery of tests ruled out their most serious concerns, and they discharged her with a ‘working diagnosis‘ of CRPS.
Following some online research, Chloe’s Mum contacted me as a result of my firm’s expertise in representing people with CRPS and other chronic pain conditions.
I immediately engaged with the police and local authority to track down the vehicle responsible. It was far from straightforward, but after finding and preserving CCTV footage and tracking down witnesses, we identified and located the driver, who was eventually charged by the police.
On presenting the evidence to the driver’s insurance company, they accepted the driver was at fault and agreed to compensate Chloe.
Subsequent progress
Chloe’s leg remained excruciatingly painful, restricting her mobility. Her pain intensified as the day went on, also changing in colour and temperature. Psychologically, it was clear the incident had a profound effect. Chloe suffered flashbacks and nightmares about the accident and avoided crossing roads, but she could not avoid passing the accident scene, which was outside her school.
A jointly instructed case manager arranged and coordinated treatment and support, paid for by the driver’s insurer. This included specialist pain physiotherapy and ongoing sessions with a child psychologist.
The case manager liaised with Chloe’s school, as she could only manage half days. As a result, we arranged private tutoring on the case manager’s recommendation. Again, funding came from the insurer. The case manager also organised an intensive private inpatient rehabilitation programme, resulting in some improvement in Chloe’s condition.
Despite not gaining the GCSE grades she hoped for, Chloe obtained an apprenticeship. However, commuting on public transport and office-based work both significantly aggravated her pain and eventually, she had to leave her job.
Longer term prognosis
Given the cautiously optimistic outcome following her residential pain management programme, Chloe attended a similar programme, this time arranged on the NHS. Again, the results were encouraging. However, although all agreed that the majority of her CRPS symptoms had now settled, Chloe continued to experience significant levels of pain following activity.
Each party obtained evidence from experts in orthopaedic surgery, pain medicine, and psychiatry. Whilst there was disagreement among the experts about the diagnosis of CRPS, there was general agreement that the accident was the triggering factor for Chloe’s pain, reduced function, and psychological problems. A comprehensive treatment plan was agreed upon, including various individual therapies aimed mainly at addressing the trauma of the accident, as well as family-based therapy.
At a joint settlement meeting, Chloe accepted an offer of settlement of £250,000 ‘in her hand’, over and above the interim payments she had already received.