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Complex Regional Pain Syndrome

(Reflex Sympathetic Dystrophy and Causalgia)

By John Markman, MD, Sri Kamesh Narasimhan, PhD

Complex regional pain syndrome (CRPS) is chronic neuropathic pain that follows soft-tissue or bone injury (type I) or nerve injury (type II) and lasts longer and is more severe than expected for the original tissue damage. Other manifestations include autonomic changes (eg, sweating, vasomotor abnormalities), motor changes (eg, weakness, dystonia), and trophic changes (eg, skin or bone atrophy, hair loss, joint contractures). Diagnosis is clinical. Treatment includes drugs, physical therapy, and sympathetic blockade.

CRPS type I was previously known as reflex sympathetic dystrophy (see also the Clinical practice guideline [third edition] for the diagnosis, treatment, and management of reflex sympathetic dystrophy/complex regional pain syndrome [RSD/CRPS] from the Reflex Sympathetic Dystrophy Syndrome Association), and type II was known as causalgia. Both types occur most often in young adults and are 2 or 3 times more common among women.

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