Complex regional pain syndrome - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Complex regional pain syndrome (CRPS) is prolonged pain, disproportionate to the initiating event, most frequently following minor trauma and most commonly affecting the distal aspect of an extremity.
Pain is often described as spontaneous, burning, lancinating, sharp, shooting, or electric. It characteristically develops dull, boring, and aching qualities with chronicity. Allodynia and hyperalgesia are almost always present.
Local edema, erythema, sweating abnormalities, and trophic skin and nail changes are often, but not always, present.
The affected extremity is often held immobile, and this can be associated with dystonia, focal weakness, and contractures.
Diagnosis is clinical. No specific tests are diagnostic; investigations may be useful to support the diagnosis or rule out alternative pathology.

Quick Reference

History & Exam
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- Other Factors
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Diagnostics Tests
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Treatment Options
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Atrophic skin and loss of hair; ulcer on right foot
Brawny edema with reddened and thickened skin, increased nail growth of great toe, and deep ulcerated lesion at top of foot
Skin shedding from arm and upper body

Citations

Key Articles

Merskey H, Bogduk N, eds. Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms. 2nd ed. Task force on Taxonomy of the International Association for the Study of Pain. Seattle, WA: IASP Press; 1994:39-43.
Goebel A, Birklein F, Brunner F, et al. The Valencia consensus-based adaptation of the IASP complex regional pain syndrome diagnostic criteria. Pain. 2021 Sep 1;162(9):2346-8.[Abstract][Full Text]
Goebel A, Barker C, Birklein F, et al. Standards for the diagnosis and management of complex regional pain syndrome: results of a European Pain Federation task force. Eur J Pain. 2019 Apr;23(4):641-51.[Abstract][Full Text]
Harden RN, McCabe CS, Goebel A, et al. Complex regional pain syndrome: practical diagnostic and treatment guidelines, 5th Edition. Pain Med. 2022 Jun 10;23(suppl 1):S1-53.[Abstract][Full Text]
Cruccu G, Aziz TZ, Garcia-Larrea L, et al. European Federation of Neurological Societies (EFNS) guidelines on neurostimulation therapy for neuropathic pain. Eur J Neurol. 2007 Sep;14(9):952-70.[Abstract][Full Text]

Other Online Resources

Reflex Sympathetic Dystrophy Syndrome Association

Referenced Articles

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