Complex Regional Pain Syndrome

Affects the limbs; pathophysiology remains unclear.

• CRPS I — follows trauma (no identifiable nerve injury).
• CRPS II — follows partial peripheral nerve injury; by definition associated with sensory and motor loss in the distribution of the affected nerve.

History

Pain worst distally, out of proportion to the inciting injury, classically described as burning. May show exaggerated sympathetic activity — temperature change, colour change, sweating, oedema, and (chronically) hair loss.

Management

• Early referral to a pain specialist.
• Early rehabilitation focused on functional restoration of the affected limb — early multidisciplinary intervention is the cornerstone of management.