Complex regional pain syndrome : mechanism, diagnosis and treatment.

Abstract

Complex regional pain syndromes (CRPS, formerly reflex sympathetic dystrophy and causalgla) are neuropathic pain disorders of one or more extremities developing inadequately after traumas or lesions in the peripheral or central nervous system (CNS). However, CPRS may also develop spontaneously. CRPS is clinically characterized by sensory (pain, hyperalgesia, and allodynia), autonomic (disturbances of skin temperature, color change, and presence of sweating abnormalities), and motor (paresis, tremor, and dystonia) disturbances. There have been growing evidences for that CRPS is a systemic disease involving the CNS and peripheral nervous system. The diagnosis is mainly based on clinical symptoms and signs, so that it could be under- or over-diagnosed. However, careful clinical evaluation and additional tests should lead to an adequate diagnosis. The goal of treatment is to improve functions, relieve pain, and achieve remission. The early diagnosis and multidisciplinary treatments, which include pain management, rehabilitation, and psychological therapy, are the most important elements for solving the patients' problems.