Complex regional pain syndrome

Mayo Clin Proc. 2002 Feb;77(2):174-80. doi: 10.4065/77.2.174.

Abstract

Complex regional pain syndrome (CRPS), formerly known as reflex sympathetic dystrophy, is a regional, posttraumatic, neuropathic pain problem that most often affects 1 or more limbs. Like most medical conditions, early diagnosis and treatment increase the likelihood of a successful outcome. Accordingly, patients with clinical signs and symptoms of CRPS after an injury should be referred immediately to a physician with expertise in evaluating and treating this condition. Physical therapy is the cornerstone and first-line treatment for CRPS. Mild cases respond to physical therapy and physical modalities. Mild to moderate cases may require adjuvant analgesics, such as anticonvulsants and/or antidepressants. An opioid should be added to the treatment regimen if these medications do not provide sufficient analgesia to allow the patient to participate in physical therapy. Patients with moderate to severe pain and/or sympathetic dysfunction require regional anesthetic blockade to participate in physical therapy. A small percentage of patients develop refractory, chronic pain and require long-term multidisciplinary treatment, including physical therapy, psychological support, and pain-relieving measures. Pain-relieving measures include medications, sympathetic/somatic blockade, spinal cord stimulation, and spinal analgesia.

Publication types

  • Review

MeSH terms

  • Acetates / therapeutic use
  • Algorithms
  • Amines*
  • Anesthesia, Conduction / methods
  • Anesthetics, Local / therapeutic use
  • Anti-Inflammatory Agents / therapeutic use
  • Antidepressive Agents / therapeutic use
  • Autonomic Nerve Block / methods
  • Complex Regional Pain Syndromes / classification
  • Complex Regional Pain Syndromes / diagnosis*
  • Complex Regional Pain Syndromes / etiology
  • Complex Regional Pain Syndromes / therapy*
  • Cyclohexanecarboxylic Acids*
  • Decision Trees
  • Electromyography
  • Gabapentin
  • Humans
  • Patient Care Team
  • Patient Selection
  • Physical Therapy Modalities
  • Referral and Consultation
  • Thermography
  • Treatment Outcome
  • gamma-Aminobutyric Acid*

Substances

  • Acetates
  • Amines
  • Anesthetics, Local
  • Anti-Inflammatory Agents
  • Antidepressive Agents
  • Cyclohexanecarboxylic Acids
  • gamma-Aminobutyric Acid
  • Gabapentin