A Solid Basic Intro to CRPS: "Pathophysiology, Diagnosis, and Treatment"

The temptation to swear off overview articles of CRPS was born of frustration, as they often seem to be mired in the outdated, and exhibit the tedium of a dashed-off requirement.  If based on a "review of articles," they sometimes contributed to the continuation of bad information.

So when Pain Medicine News, "The Independent Newspaper for Pain Management," published "Complex Regional Pain Syndrome: Pathophysiology, Diagnosis, and Treatment," I almost submitted to the usual Pavlovian response and let behavior modification take over.  So glad that I did not cave in, as this is a succinct and intelligent overview of CRPS, and locates well where the scientific/medical world ought to be, were things ever in synchronicity!

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Complex Regional Pain Syndrome: Pathophysiology, Diagnosis, and Treatment ISSUE: DECEMBER 2014

Boris Yaguda, MD; Paul Shekane, MD; Christopher Gharibo, MD

Boris Yaguda, MD

Fellow in Pain Medicine
Center for the Study of Treatment of Pain
Department of Anesthesiology
New York University Medical Center
New York, New York

Paul Shekane, MD

Resident
Department of Anesthesiology
New York University Medical Center
New York, New York

Christopher Gharibo, MD

Associate Professor of Anesthesiology & Orthopedics
Center for Study & Treatment of Pain
NYU Langone - Hospital for Joint Diseases
New York, New York

Complex regional pain syndrome (CRPS) is a chronic, predominantly neuropathic and partly musculoskeletal pain disorder often associated with autonomic disturbances. It is divided into 2 types, reflecting the absence or presence of a nerve injury.

Patients with either type may exhibit symptoms such as burning pain, hyperalgesia, and/or allodynia with an element of musculoskeletal pain. CRPS can be distinguished from other types of neuropathic pain by the presence of regional spread as opposed to a pattern more consistent with neuralgia or peripheral neuropathy. Autonomic dysfunction (such as altered sweating, changes in skin color, or changes in skin temperature); trophic changes to the skin, hair, and nails; and altered motor function (such as weakness, muscle atrophy, decreased range of motion, paralysis, tremor, or spasticity) also can be present.

[Granted, a perfunctory beginning, but that's how these things must begin!  Please read the rest HERE.]

To download the article as a PDF document, click HERE.   

There are, to finish the heaping on of praise, some excellent summary schematics/tables, such as this overview of how treatment modalities might flow:

Figure 2. Schematic representation of treatment modalities based on pathophysiologic mechanisms.7