A medical mystery of complex regional pain syndrome

Jabril Eldufani, Nyruz Elahmer, Gilbert Blaise, Jabril Eldufani, Nyruz Elahmer, Gilbert Blaise

Abstract

Complex regional pain syndrome (CRPS) is a condition of neuropathic pain, which is characterized by significant autonomic and inflammatory features. CRPS occurs in patients who have limb surgery, limb fractures, or trauma. Many patients may have pain resolve within twelve months of the inciting incident; however, a small subset progresses to the chronic form. This transitional process often happens by changing from warm CRPS with dominant inflammatory phase to cold CRPS, in which autonomic characteristics or manifestations dominate. Several peripheral and central mechanisms are involved, which might vary among individuals over a period of time. Other contributors include peripheral and central sensitization, autonomic alterations, inflammatory and immune changes, neurochemical changes, and psychological and genetic factors. Although effective management of the chronic CRPS form is often challenging, there are a few high quality randomized controlled trials that support the efficacy of the most commonly used therapeutic approaches.

Keywords: CRPS; Future therapy; Health sciences; Neurology; Neuroscience; Pain; Pain management; Pain research; Pathophysiology; Surgery; Treatment.

© 2020 Published by Elsevier Ltd.

Figures

Figure 1
Figure 1
Research strategy: A graph representation.
Figure 2
Figure 2
The speculative model illustrates the interacting different pathophysiological mechanisms of complex regional pain syndrome.
Figure 3
Figure 3
The Summarized algorithm of management CRPS that explains multiple therapeutic approaches and interventions depend on the severity of the condition.

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