Evidence-Based Therapeutic Methods for Reflex Sympathetic Dystrophy: A Systematic Review

Complex regional pain syndrome (CRPS) is a chronic pain illness characterized by ongoing discomfort, sensory abnormalities, motor dysfunction, edema, and decreased functional capacity. Although different therapeutic options have been presented, the efficacy of physical rehabilitation and pharmaceutical therapies is still under research. This systematic review sought to assess the existing data on the efficacy of physiotherapy rehabilitation and pharmaceutical therapies in improving pain, function, and quality of life in people with CRPS. A systematic review of randomized controlled trials (RCTs) published between 2016 and 2024 was conducted. Electronic databases, including PubMed, Scopus, PEDro, Cochrane Library, and Google Scholar, were searched. RCTs published in English that investigated physiotherapy rehabilitation or pharmacological interventions for CRPS were included. Fourteen studies met the eligibility criteria. Methodological quality was assessed using a standardized risk-of-bias assessment tool. Due to heterogeneity among interventions and outcome measures, a narrative synthesis was performed. Fourteen RCTs met the inclusion criteria. Overall, interventions demonstrated improvements in pain, functional capacity, and quality of life; however, the magnitude and consistency of treatment effects varied substantially across studies. The results imply that current CRPS therapeutic options may improve pain, function, and quality of life; however, treatment efficacy differs between trials. Key obstacles include diverse clinical presentations, a lack of defined treatment methods, and insufficient long-term data. Future research should focus on creating standardized diagnostic criteria, accurate biomarkers, personalized treatment techniques, and large-scale clinical trials to enhance patient outcomes. The findings indicate that physiotherapy rehabilitation is important in the treatment of CRPS and can successfully improve pain and functional performance. Neridronate appeared to be the most promising pharmaceutical strategy in the research reviewed. However, the heterogeneity in treatment methods, outcome measures, and sample sizes restricts the generalizability of the results. More large-scale, high-quality randomized controlled studies are needed to provide uniform treatment guidelines and maximize clinical outcomes in patients with CRPS.