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Complex Regional Pain Syndrome.

Updated: Jan 31, 2021



Epidemiology

Results from a traumatic insult, with a prevalence of approximately 5.4–26.2 per 100 000 person years.


It can be further divided into two subtypes, based on the absence (CRPS I, previously known as reflex sympathetic dystrophy) or presence (CRPS II, previously known as causalgia) of a major nerve injury.

Pathophysiology


It is distinct from other pain syndromes by the presence of autonomic dysfunction, persistent regional inflammatory changes, and a lack of dermatomal distribution. It commonly presents with allodynia, hyperalgesia, skin temperature changes, and oedema. Epidemiologic trends suggest that being female, having an upper extremity injury, and suffering high-energy trauma places patients at an increased risk of developing this disorder.1


Presentation


Examination


Investigations


Treatment


Complications


Golden pearls


References / Articles / Resources

Essential reading:


Bruehl, S. 2010. ‘An update on the pathophysiology of complex regional pain syndrome’. Anesthesiology 113 (3): 713–25.


de Jong, JR, Vlaeyen, JW, de Gelder, JM, Patijn, J. 2011. ‘Pain-related fear, perceived harmfulness of activities, and functional limitations in complex regional pain syndrome type I’. The journal of pain 12 (12): 1209–18. EZ


Harden, RN, Oaklander, AL, Burton, AW, Perez, RS, Richardson, K, Swan, M, et al. 2013. ‘Complex regional pain syndrome: practical diagnostic and treatment guidelines (4th edition)’. Pain medicine 14 (2): 180–229. EZ


Legrain, V, Bultitude, JH, de Paepe, AL, Rossetti, Y. 2012. ‘Pain, body, and space: what do patients with complex regional pain syndrome really neglect?’ Pain 153 (5): 948–51. PDF


Lohnberg, JA, Altmaier, EM. 2013. ‘A review of psychosocial factors in complex regional pain syndrome’. Journal of clinical psychology in medical settings 20 (2): 247–54. EZ

Marinus, J, Moseley, GL, Birklein, F, Baron, R, Maihofner, C, Kingery, WS et al. 2011.



​Shibuya, N, Humphers, JM, Agarwal, MR, Jupiter, DC. 2013. ‘Efficacy and safety of high-dose vitamin C on complex regional pain syndrome in extremity trauma and surgery: systematic review and meta-analysis’. Journal of foot and ankle surgery 52 (1): 62–6. PDF






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