Complex Regional Pain Syndrome

Complex regional pain syndrome (CRPS) is a challenging pain condition with incompletely elucidated pathophysiology, most often affecting a single extremity after an inciting injury. The most common clinical finding is burning pain out of proportion to any identifiable initiating event, with a combination of sensory, vasomotor, sudomotor, and motor/trophic signs and symptoms. The management of CRPS emphasizes early diagnosis and aggressive multimodal treatment based on physical therapy, psychological therapy, and pain management with frequent reassessments of patient progression. In order to prevent permanent life-altering disability, all modalities including interventional therapies should be escalated in tandem, based on assessments of patient responsiveness. Clinicians should consider escalating therapy frequently if no improvement is observed, and introducing psychological evaluation if symptoms persist. Lastly, the use of interventional techniques such as sympathetic blocks or spinal cord stimulation should be employed early in refractory cases.