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Published on: January 21, 2020
Complex regional pain syndrome: a review
Raneem Albazaz1, Yew Toh Wong, Shervanthi Homer-Vanniasinkam
1Leeds Vascular Institute, The General Infirmary at Leeds, Leeds, UK. raneemalbazaz@hotmail.com
Annals of Vascular Surgery
|March 19, 2008
Summary
Complex regional pain syndrome (CRPS) is a chronic neurological disorder causing severe pain. Evidence for CRPS treatments is limited, highlighting the need for early recognition and multidisciplinary care.
Area of Science:
- Neurology
- Pain Management
- Rehabilitation Medicine
Background:
- Complex regional pain syndrome (CRPS), previously reflex sympathetic dystrophy, is a chronic neurological disorder.
- Characterized by severe pain, swelling, vasomotor dysfunction, and motor impairment, often following minor trauma.
- Diagnosis relies on clinical presentation and history due to lack of specific tests.
Purpose of the Study:
- To provide a synopsis of CRPS.
- To discuss management principles based on existing literature.
- To identify evidence gaps in CRPS treatment.
Main Methods:
- Comprehensive literature search of electronic databases (Medline, Embase, Pubmed, CENTRAL) from 1970-2006.
- Keywords included 'complex regional pain syndrome', 'reflex sympathetic dystrophy', 'neuropathic pain', and 'causalgia'.
- Analysis of 3,771 articles, focusing on 76 randomized controlled trials.
Main Results:
- Limited high-quality evidence exists for CRPS treatment.
- Bisphosphonates, cognitive behavioral therapy, physiotherapy, occupational therapy, spinal cord stimulation, acupuncture, vitamin C, and steroids showed potential benefits.
- The efficacy of sympathetic blockade and sympathectomy remains unclear, with mixed results and small study sizes.
Conclusions:
- Early recognition and a multidisciplinary approach are crucial for optimal CRPS outcomes.
- Pain reduction and limb function rehabilitation are primary therapeutic goals.
- Concurrent treatment of comorbidities like depression and anxiety is essential.
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