Complex Regional Pain Syndrome Type I and risk factors in adult population: A systematic review

Abstract

Introduction

Complex Regional Pain Syndrome Type I (CRPS-I) is a chronic and debilitating condition characterized by unclear pathophysiology and controversial treatment options. This study aims to identify specific factors associated with CRPS-I development.

Methods

A systematic review was conducted following the PRISMA guidelines. An extensive electronic search was performed across six databases: MEDLINE, Cochrane, Google Scholar, Web of Science, Scopus, and Embase. Only case–control and cohort studies that identified CRPS-I adult patients’ risk factors were included. Out of 708 initially identified studies, 9 met the eligibility criteria. The risk of bias was assessed using the Newcastle–Ottawa scale.

Results

The review identified 13 distinct variables related to CRPS-I development. Key factors included upper limb fractures with high pain levels (over 5/10 on a numeric rating scale), significantly associated with increased CRPS-I risk (OR: 3.6). Additional significant risk factors included female gender and comorbidities like migraines (OR: 2.7), fibromyalgia (OR: 2.5), and rheumatoid arthritis (OR: 2.1). Fracture characteristics, such as high-impact injuries or open surgical reductions, were also contributing factors (OR: 1.3). Psychological, genetic, and metabolic factors also played roles in CRPS-I development.

Conclusion

Despite the low risk of bias in the included studies, the results were inconsistent for a meta-analysis, highlighting the need for further research to clarify these associations. The review emphasizes the importance of fracture management, hormonal influences, and genetic predispositions in CRPS-I. Future research should explore genetic, hormonal, and inflammatory interactions to enhance understanding and treatment strategies for CRPS-I.