[Complex Regional Pain Syndrome-An Update]

Overview

Journal Schmerz

Date 2022 Mar 22

PMID 35316391

Authors

Cora Rebhorn

Violeta Dimova

Frank Birklein

Affiliations

Soon will be listed here.

Abstract

Complex regional pain syndrome (CRPS) is a pain disorder that develops in the hands or feet after injury. Currently, two types are differentiated, CRPS I without and CRPS II with nerve lesions as well as with either an initially warm or an initially cold subtype, depending on the clinical symptoms. After trauma a certain amount of inflammatory reaction is considered physiological. In acute CRPS this inflammation persists for months and is maintained by diverse inflammatory mediators in peripheral tissue and in blood. This persisting inflammation leads to a sensitization of the nociceptive system, causes somatic cells to proliferate and gives rise to a disrupted endothelial function. The treatment concept aims to antagonize the pathophysiologic components and includes anti-inflammatory and analgetic treatment, mobilization and restoration of the sensorimotor function of the affected limb.

Citing Articles

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Harnik M, Kindl G, Birklein F, Rittner H Schmerz. 2025; .

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[Cognitive behavioral therapy for complex regional pain syndrome].

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References

Moseley G, Herbert R, Parsons T, Lucas S, van Hilten J, Marinus J . Intense pain soon after wrist fracture strongly predicts who will develop complex regional pain syndrome: prospective cohort study. J Pain. 2013; 15(1):16-23. DOI: 10.1016/j.jpain.2013.08.009. View

Peltz E, Seifert F, Lanz S, Muller R, Maihofner C . Impaired hand size estimation in CRPS. J Pain. 2011; 12(10):1095-101. DOI: 10.1016/j.jpain.2011.05.001. View

Bruehl S, Maihofner C, Stanton-Hicks M, Perez R, Vatine J, Brunner F . Complex regional pain syndrome: evidence for warm and cold subtypes in a large prospective clinical sample. Pain. 2016; 157(8):1674-81. DOI: 10.1097/j.pain.0000000000000569. View

Wertli M, Bachmann L, Weiner S, Brunner F . Prognostic factors in complex regional pain syndrome 1: a systematic review. J Rehabil Med. 2013; 45(3):225-31. DOI: 10.2340/16501977-1103. View

Mainka T, Bischoff F, Baron R, Krumova E, Nicolas V, Pennekamp W . Comparison of muscle and joint pressure-pain thresholds in patients with complex regional pain syndrome and upper limb pain of other origin. Pain. 2013; 155(3):591-597. DOI: 10.1016/j.pain.2013.12.014. View

Frettloh J, Huppe M, Maier C . Severity and specificity of neglect-like symptoms in patients with complex regional pain syndrome (CRPS) compared to chronic limb pain of other origins. Pain. 2006; 124(1-2):184-9. DOI: 10.1016/j.pain.2006.04.010. View

van Rooijen D, Geraedts E, Marinus J, Jankovic J, van Hilten J . Peripheral trauma and movement disorders: a systematic review of reported cases. J Neurol Neurosurg Psychiatry. 2011; 82(8):892-8. DOI: 10.1136/jnnp.2010.232504. View

Bean D, Johnson M, Kydd R . Relationships between psychological factors, pain, and disability in complex regional pain syndrome and low back pain. Clin J Pain. 2013; 30(8):647-53. DOI: 10.1097/AJP.0000000000000007. View

Harden N, Bruehl S, Perez R, Birklein F, Marinus J, Maihofner C . Validation of proposed diagnostic criteria (the "Budapest Criteria") for Complex Regional Pain Syndrome. Pain. 2010; 150(2):268-274. PMC: 2914601. DOI: 10.1016/j.pain.2010.04.030. View

10.

Beerthuizen A, Stronks D, Vant Spijker A, Yaksh A, Hanraets B, Klein J . Demographic and medical parameters in the development of complex regional pain syndrome type 1 (CRPS1): prospective study on 596 patients with a fracture. Pain. 2012; 153(6):1187-1192. DOI: 10.1016/j.pain.2012.01.026. View

11.

van Bussel C, Stronks D, Huygen F . Complex regional pain syndrome type I of the knee: a systematic literature review. Eur J Pain. 2013; 18(6):766-73. DOI: 10.1002/j.1532-2149.2013.00434.x. View

12.

Krumova E, Frettloh J, Klauenberg S, Richter H, Wasner G, Maier C . Long-term skin temperature measurements - a practical diagnostic tool in complex regional pain syndrome. Pain. 2008; 140(1):8-22. DOI: 10.1016/j.pain.2008.07.003. View

13.

Wuppenhorst N, Maier C, Frettloh J, Pennekamp W, Nicolas V . Sensitivity and specificity of 3-phase bone scintigraphy in the diagnosis of complex regional pain syndrome of the upper extremity. Clin J Pain. 2010; 26(3):182-9. DOI: 10.1097/AJP.0b013e3181c20207. View

14.

Kramer H, Hofbauer L, Szalay G, Breimhorst M, Eberle T, Zieschang K . Osteoprotegerin: a new biomarker for impaired bone metabolism in complex regional pain syndrome?. Pain. 2014; 155(5):889-895. DOI: 10.1016/j.pain.2014.01.014. View

15.

Dimova V, Herrnberger M, Escolano-Lozano F, Rittner H, Vlckova E, Sommer C . Clinical phenotypes and classification algorithm for complex regional pain syndrome. Neurology. 2019; 94(4):e357-e367. DOI: 10.1212/WNL.0000000000008736. View

16.

Schlereth T, Breimhorst M, Werner N, Pottschmidt K, Drummond P, Birklein F . Inhibition of neuropeptide degradation suppresses sweating but increases the area of the axon reflex flare. Exp Dermatol. 2013; 22(4):299-301. DOI: 10.1111/exd.12122. View

17.

Birklein F, Drummond P, Li W, Schlereth T, Albrecht N, Finch P . Activation of cutaneous immune responses in complex regional pain syndrome. J Pain. 2014; 15(5):485-95. PMC: 4011956. DOI: 10.1016/j.jpain.2014.01.490. View

18.

Lenz F, Gracely R, Romanoski A, HOPE E, Rowland L, Dougherty P . Stimulation in the human somatosensory thalamus can reproduce both the affective and sensory dimensions of previously experienced pain. Nat Med. 1995; 1(9):910-3. DOI: 10.1038/nm0995-910. View

19.

Weber M, Birklein F, Neundorfer B, Schmelz M . Facilitated neurogenic inflammation in complex regional pain syndrome. Pain. 2001; 91(3):251-257. DOI: 10.1016/S0304-3959(00)00445-0. View

20.

Groeneweg J, Huygen F, Heijmans-Antonissen C, Niehof S, Zijlstra F . Increased endothelin-1 and diminished nitric oxide levels in blister fluids of patients with intermediate cold type complex regional pain syndrome type 1. BMC Musculoskelet Disord. 2006; 7:91. PMC: 1693561. DOI: 10.1186/1471-2474-7-91. View