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Complex regional pain syndrome type I: a comprehensive review
Author(s) -
Bussa M.,
Guttilla D.,
Lucia M.,
Mascaro A.,
Rinaldi S.
Publication year - 2015
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.12489
Subject(s) - medicine , complex regional pain syndrome , modalities , nociception , chronic pain , reflex , physical medicine and rehabilitation , intensive care medicine , physical therapy , anesthesia , social science , receptor , sociology
Background Complex regional pain syndrome type I ( CRPS I), formerly known as reflex sympathetic dystrophy ( RSD ), is a chronic painful disorder that usually develops after a minor injury to a limb. This topical review gives a synopsis of CRPS I and discusses the current concepts of our understanding of CRPS I in adults, the diagnosis, and treatment options based on the limited evidence found in medical literature. CRPS I is a multifactorial disorder. Possible pathophysiological mechanisms of CRPS I are classic and neurogenic inflammation, and maladaptive neuroplasticity. At the level of the central nervous system, it has been suggested that an increased input from peripheral nociceptors alters the central processing mechanisms. Methods A literature search was conducted using, as electronic bibliographic database, Medline from 1980 until 2014. Results An early diagnosis and multidisciplinary treatment are necessary to prevent permanent disability. Conclusions The pharmacological treatment of CRPS I is empirical and insufficiently effective. Further research is needed regarding the therapeutic modalities discussed in the guidelines. Physical therapy is widely recommended as a first‐line treatment. The efficacy of local anesthetic sympathetic blockade as treatment for CRPS I is questionable.