A brief review of complex regional pain syndrome and current management.

Complex regional pain syndrome (CRPS) is a rare but debilitating chronic pain condition with a complex and poorly understood pathophysiology, making diagnosis and treatment challenging. Diagnosis is by exclusion, and the Budapest diagnostic criteria have helped standardize definitions, but the underlying pathways remain unclear. Two types exist: CRPS type 1 (no neuronal injury) and type 2 (with neuronal injury). Management ranges from non-invasive therapies like physical and psychological therapy to invasive options such as dorsal root ganglion stimulation and amputation. Multimodal treatment is ideal, but more research is needed to understand CRPS development and to conduct robust clinical trials for therapies.

Study at a glance

Abstract

Complex regional pain syndrome (CRPS) is a debilitating chronic pain condition that, although exceedingly rare, carries a significant burden for the affected patient population. The complex and ambiguous pathophysiology of this condition further complicates clinical management and therapeutic interventions. Furthermore, being a diagnosis of exclusion requires a diligent workup to ensure an accurate diagnosis and subsequent targeted management. The development of the Budapest diagnostic criteria helped to consolidate existing definitions of CRPS but extensive work remains in identifying the underlying pathways. Currently, two distinct types are identified by the presence (CRPS type 1) or absence (CRPS type 2) of neuronal injury. Current management directed at this disease is broad and growing, ranging from non-invasive modalities such as physical and psychological therapy to more invasive techniques such as dorsal root ganglion stimulation and potentially amputation. Ideal therapeutic interventions are multimodal in nature to address the likely multifactorial pathological development of CRPS. Regardless, a significant need remains for continued studies to elucidate the pathways involved in developing CRPS as well as more robust clinical trials for various treatment modalities.