Complex Regional Pain Syndrome

Jiaxin Tran, V. S. Ramachandran, Eric L. Altschuler

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review


Complex regional pain syndrome (CRPS) is an enigmatic condition that is often difficult to treat. CRPS type I does not involve injury to a nerve, whereas type II does involve nerve injury. With both types, the patient presents with pain out of proportion to the original injury. The pain can spread in a limb well beyond the injury site. There can be hair, nail, and skin changes, and in severe cases may progress to pachydermia. The etiology of CRPS remains unknown; however, central cortical and subcortical sensory and motor remapping after injury may play a role. Treatment is a challenge. No medication has been shown significantly beneficial in controlled studies. Nerve blocks help in some cases. Return of active movement and weight bearing, along with decreased pain, are clearly the therapeutic goals. If appropriate, a trial of pain medications, nerve blocks, and physical modalities can be used as adjuvants along with physical or occupation therapy to manage symptoms. Mirror therapy may also be a useful active assist adjuvant and has shown promise in case reports and initial studies.

Original languageEnglish
Title of host publicationEssentials of Physical Medicine and Rehabilitation
Subtitle of host publicationMusculoskeletal Disorders, Pain, and Rehabilitation
Number of pages6
ISBN (Electronic)9780323549479
StatePublished - 1 Jan 2018
Externally publishedYes


  • Causalgia
  • Central pain
  • Chronic pain
  • Chronic regional pain syndrome
  • Mirror therapy
  • Reflex sympathetic dystrophy


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