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Related Experiment Videos

Complex regional pain syndrome.

Michael Stanton-Hicks1

  • 1Division of Anesthesiology for Pain Management and Research, The Cleveland Clinic, 9500 Euclid Avenue, Desk C-25, Cleveland, OH 44195, USA. stanton@ccf.org

Anesthesiology Clinics of North America
|January 15, 2004
PubMed
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Complex regional pain syndrome (CRPS) involves the brain, affecting sensory, sympathetic, and motor systems. Current management focuses on rehabilitation, utilizing various tests to guide treatment for sympathetically maintained pain.

Area of Science:

  • Neurology
  • Pain Medicine
  • Rehabilitation Medicine

Background:

  • Complex regional pain syndrome (CRPS) I and II pathophysiology remains incompletely understood, despite advances in clinical management and research.
  • Emerging evidence indicates CRPS represents a complex neurological disease impacting multiple integrated brain levels.
  • CRPS I involves significant alterations in somatosensory, sympathetic, and somatomotor systems.

Purpose of the Study:

  • To review current understanding of CRPS pathophysiology and diagnostic approaches.
  • To highlight the role of advanced testing in assessing CRPS-related system changes.
  • To discuss the current rehabilitation-based management model for CRPS.

Main Methods:

  • Review of current literature on CRPS pathophysiology and diagnostics.

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  • Description of diagnostic tests including quantitative sensory testing (QST), autonomic function tests (e.g., QSART), cold pressor test with thermography, and laser Doppler flowmetry.
  • Discussion of therapeutic modalities within a rehabilitation framework.

    • Main Results:

    • CRPS involves the brain, affecting somatosensory, sympathetic, and somatomotor functions.
    • Specific tests can now assess these system changes, aiding in diagnosis despite the absence of a definitive lab test.
    • Motor disorder recognition is crucial and may be incorporated into future diagnostic criteria.

    Conclusions:

    • Current CRPS management relies on a rehabilitation model, integrating various therapeutic strategies.
    • Minimizing joint movement during physiotherapy is key to reducing pain and improving patient compliance.
    • Sympatholysis can be a useful procedure for treating sympathetically maintained pain, but is not a standalone diagnostic test.