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Complex Regional Pain Syndrome 

Complex Regional Pain Syndrome
Chapter:
Complex Regional Pain Syndrome
Author(s):

Salim M. Hayek

and Henry E. Vucetic

DOI:
10.1093/med/9780199859436.003.0014
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date: 21 April 2021

Complex regional pain syndrome (CRPS) is one of the most difficult pain conditions to treat, being fraught with challenges resulting from diagnostic ambiguities, and the lack of any reliably identifiable pathophysiological mechanisms with which to target treatment. There are two types of CRPS, type I and type II, with the distinction being that CRPS involves direct injury to a major nerve. Estimates of the prevalence of CRPS vary widely, from < 5% to upwards of 20% for some injuries. Current criteria require at least one symptom in 3, and one sign in 2, of the following categories: sensory, motor, vasomotor (e.g. temperature or skin color asymmetry) and sudomotor (e.g. sweating or edema). The treatment of CRPS is similar to that for other neuropathic pain conditions to include membrane stabilizers and tricyclic antidepressants. High grade evidence also exists for bisphosphonates as a treatment, and vitamin C as a prophylactic regimen prior to surgery in high-risk individuals. In individuals who fail pharmacological therapy, spinal cord stimulation has been shown to provide long-term benefit.

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