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.
Affected extremity is often held immobile, resulting in dystonia, focal weakness, and contractures, probably due to disuse.
Diagnosis is clinical. No specific tests are diagnostic for this condition.
The main focus of treatment is adequate analgesia and improvement of mobility and function.
Complex regional pain syndrome (CRPS) is defined as continuing (spontaneous and/or evoked) regional pain 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.
Adjunct Clinical Professor
Department of Neurology
Tufts University School of Medicine
SHH declares that he has no competing interests.
Department of Neurological Surgery
Weill Cornell Medical College
New York-Presbyterian Hospital
AT declares that he has no competing interests.
Associate Chief of Rheumatology
VA Greater Los Angeles Healthcare System
Associate Professor of Medicine
David Geffen School of Medicine
AW declares that he has no competing interests.
Consultant in Pain Management and Anaesthesia
Pain Management Department
Royal National Orthopaedic Hospital NHS Trust
JB has been reimbursed by Pfizer for a number of lectures given at Pfizer-sponsored meetings and courses.
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