Complex regional pain syndrome
| Complex regional pain syndrome | |
|---|---|
| Other names | Algodystrophy, reflex neurovascular dystrophy |
| Leg of an individual (left) with complex regional pain syndrome following a tibial fracture | |
| Specialty | Neurology, psychiatry, physiatry, anesthesiology |
| Symptoms | Pain, hyperalgesia, allodynia, hypoesthesia or hyperesthesia, skin abnormalities, atrophy, stiffness, temperature asymmetry |
| Types | CRPS-1 (previously, reflex sympathetic dystrophy [RSD]); CRPS-2 (previously, causalgia) |
| Treatment | Physical therapy (more effective with early diagnosis); medications (e.g., anticonvulsants, opioids, & muscle relaxers); spinal cord stimulator implantation; peripheral nerve stimulator implantation; sympathetic nerve blockade; ketamine infusion; lidocaine infusion; implantable pharmaceuticals; amputation |
| Medication | Anticonvulsants (e.g., gabapentin); muscle relaxers (e.g., baclofen), ketamine or lidocaine infusions |
Complex regional pain syndrome (CRPS type 1 and type 2), sometimes referred to by the hyponyms reflex sympathetic dystrophy (RSD) or reflex neurovascular dystrophy (RND), is a rare and severe form of neuroinflammatory and dysautonomic disorder causing chronic pain, neurovascular, and neuropathic symptoms. Although it can vary widely, the classic presentation occurs when severe pain from a physical trauma or neurotropic viral infection outlasts the expected recovery time, and may subsequently spread to uninjured areas. The symptoms of types 1 and 2 are the same, except type 2 is associated with nerve injury.
Usually starting in a single limb, CRPS often first manifests as pain, swelling, limited range of motion, or partial paralysis, and/or changes to the skin and bones. It may initially affect one limb and then spread throughout the body; 35% of affected individuals report symptoms throughout the body. Two types are thought to exist: CRPS type 1 (previously referred to as reflex sympathetic dystrophy) and CRPS type 2 (previously referred to as causalgia). It is possible to have both types.
Amplified musculoskeletal pain syndrome, a condition that is similar to CRPS, primarily affects pediatric patients, falls under rheumatology and pediatrics, and is generally considered a subset of CRPS type I.