Complex Regional Pain Syndrome

Complex regional pain syndrome (CRPS) is a chronic pain condition with associated edema, skin color and temperature changes. CRPS can be spontaneous or induced by a specific stimulus and is commonly associated with motor and sensory changes leading to significant disability. The incidence and prevalence of CRPS is variable and more commonly affects females and upper extremities with peak incidence at 50-70 years of age. The pathophysiology of CRPS is complex and involves multiple factors including neurological, inflammatory, psychological, and genetic factors. CRPS treatment is multidisciplinary and includes pharmacotherapy, physical and psychological therapy and interventions to reduce sympathetic activity. Physical and psychological therapy are considered the mainstay of CRPS treatment and should be coupled with medications such as anti-inflammatory, neuropathic and opioid drugs to reduce symptoms. Patients with intractable pain can be offered interventions including sympathetic block, sympathectomy, dorsal root ganglion, and spinal cord stimulation with variable results.