Complex regional pain syndrome

Prolonged pain, disproportionate to the initiating event, most frequently following minor trauma and most commonly affecting the distal aspect of an extremity.

Pain often described as spontaneous, burning, lancinating, sharp, shooting, or electric. Characteristically develops dull, boring, and aching qualities with chronicity. Allodynia and hyperalgesia are almost always present.

Local oedema, 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.

The treatment goal is functional restoration of a limb by using adequate pain management techniques, with patient education, physiotherapies, pharmacotherapy, and appropriate psychological techniques tailored to the individual patient.

Complex regional pain syndrome (CRPS) is defined as continuing (spontaneous and/or evoked) regional pain that is out of proportion to the severity of the inciting event and beyond the normal time frame expected following the event. The pain is usually regional (not in a specific nerve territory or dermatome) and has a distal predominance of abnormal sensory, motor, sudomotor, vasomotor, and/or trophic findings with variable progression over time.