Complex regional pain syndrome: a review

J Hand Surg Eur Vol. 2013 Jul;38(6):616-26. doi: 10.1177/1753193412471021. Epub 2013 Jan 22.


Complex regional pain syndrome, formally known as reflex sympathetic dystrophy, is a poorly understood condition that describes a collection of clinical symptoms and signs occurring in the peripheries most commonly after trauma. Pain is the main problem. It is generally out of proportion to the degree of injury and can be unresponsive to narcotics. In addition joint stiffness, temperature and colour changes, and swelling occur. The diagnosis and treatment are challenging for any clinician and a multidisciplinary approach is often necessary with physiotherapy, occupational therapy, and the pain team. The hand surgeon is involved for two reasons, firstly as the upper limb is the most frequently involved, and secondly because the condition may be a complication of the patient's surgery and result in a much prolonged recovery. This review elucidates the recent advances in the knowledge of the aetiology, classification and treatment of this fascinating condition.

Keywords: Complex regional pain syndrome; Reflex sympathetic dystrophy.

Publication types

  • Review

MeSH terms

  • Complex Regional Pain Syndromes / diagnosis*
  • Complex Regional Pain Syndromes / etiology
  • Complex Regional Pain Syndromes / physiopathology
  • Complex Regional Pain Syndromes / therapy
  • Diagnostic Errors / legislation & jurisprudence
  • Edema / etiology
  • Feedback
  • Hair / abnormalities
  • Humans
  • Hyperalgesia / etiology
  • Incidence
  • Inflammation / complications
  • Malpractice
  • Movement / physiology
  • Muscle Weakness / etiology
  • Nails, Malformed
  • Neuralgia / complications
  • Physical Therapy Modalities
  • Vasomotor System / physiopathology