Taking a Look at Complex Regional Pain Syndrome

Many clinicians are eager to understand the symptoms and manifestations leading to a diagnosis of complex regional pain syndrome (CRPS), an uncommon and often misunderstood condition.

In addition to classic neuropathic complaints, CRPS has its own set of symptoms: allodynia; hyperalgesia; swelling; skin color changes; trophic changes to hair or skin, or both; and end stage-altered motor function. It is important to remember, however, that symptoms are not always present after the precipitating trauma.¹

“CRPS is an uncommon pain diagnosis,” said Peter Pryzbylkowski, MD. “The triad of pain out of proportion to the inciting event, color changes, and nondermatomal distribution of pain should trigger thoughts for the primary care provider of the diagnosis of CRPS. Other signs and symptoms that may be seen in a patient with CRPS include temperature differences in the affected extremity, changes in sweating or hair growth, and edema.”

He continued: “There is still no robust evidence guiding the treatment algorithm for patients with CRPS. The current consensus is that a trial of neuropathic pain agents should be initiated in these patients, and interventional procedures should be entertained sooner rather than later.”

Describing the epidemiology and pathophysiology of CRPS can be challenging as the diagnosis is not always clear, Dr. Pryzbylkowski noted during his presentation. For example, patients often see clinicians from multiple specialties before they are diagnosed with CRPS.