Complex Regional Pain Syndrome CRPS; chronic pain condition usually develops after injury, surgery

Описание: Complex Regional Pain Syndrome (CRPS) is a chronic pain condition that usually develops after an injury, surgery, stroke, or heart attack, but the pain experienced is out of proportion to the initial injury. It involves abnormal responses of the nervous system and can affect the skin, muscles, joints, and blood vessels of the affected limb.

Types of CRPS
CRPS Type I (Reflex Sympathetic Dystrophy)

Occurs without a confirmed nerve injury.

More common form.

CRPS Type II (Causalgia)

Occurs with a confirmed nerve injury.

Usually more localized but severe.

Key Features
Pain: Severe, burning, or throbbing pain disproportionate to injury.

Sensory changes: Allodynia (pain from light touch), hyperalgesia (increased pain sensitivity).

Autonomic changes: Skin temperature differences, color changes, abnormal sweating.

Motor/trophic changes: Muscle weakness, tremors, joint stiffness, brittle nails, shiny skin, hair loss.

Swelling: Edema in the affected limb.

Pathophysiology
Not fully understood.

Involves abnormal interaction between peripheral and central nervous systems.

Dysregulation of inflammatory and autonomic pathways (sympathetic nervous system).

Possible role of genetic predisposition and immune system activation.

Diagnosis
Clinical diagnosis based on history and symptoms.

Budapest Criteria are widely used:

Continuing pain disproportionate to injury.

At least one symptom in ≥3 categories (sensory, vasomotor, sudomotor/edema, motor/trophic).

At least one sign in ≥2 categories on exam.

Imaging (bone scans, MRI) and labs may support but are not definitive.

Management
Multidisciplinary approach:

Medications: NSAIDs, corticosteroids, neuropathic pain agents (gabapentin, pregabalin), bisphosphonates.

Physical therapy: Maintain mobility, prevent contractures.

Psychological support: CBT, coping strategies.



#Regional