Complex Regional Pain Syndrome Type 1: Diagnosis and Management

J Hand Surg Asian Pac Vol. 2018 Mar;23(1):1-10. doi: 10.1142/S2424835518300013.


Diagnosis of Complex regional pain syndrome (CRPS) is made primarily on a clinical basis, and no specific test is known to confirm or exclude CRPS diagnosis. That is, there aren't specific diagnostic tools and instrumental tests are made only for identifying an etiology at the basis of the CRPS. Numerous therapeutic methods have been introduced, but none have shown definitive results. When symptoms persist, patients experience permanent impairment and disability. Therefore, early recognition of CRPS, along with proper treatment, is important for minimizing permanent loss of function. As there is no gold standard test for CRPS, several clinical diagnostic criteria have been introduced and applied in various studies. However, to date, no formal or standardized diagnostic criteria for CRPS have been widely accepted. However, the Budapest diagnostic criteria have recently increased in popularity and are frequently used in scientific studies. The goal for management of CRPS is the return of normal limb function. No specific technique has been shown to prevent CRPS following surgery, but avoidance of prolonged immobilization may be important. Therefore, initiating early post-surgical rehabilitation, where possible, is important. A multidisciplinary approach would seem to be optimal, above all things objectives of physical and occupational therapy are fulfilled with combination pharmacotherapy due to provide pain relief to facilitate physical rehabilitation. Future research using large randomized controlled trials should focus on collecting strong evidence for the etiology of CRPS, testing pharmacological effects, and determining appropriate combination treatment strategies.

Keywords: Complex regional pain syndrome; Diagnostic criteria for CRPS; Interventional and surgical therapy; Pharmacotherapy; Psychological intervention.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Anticonvulsants / therapeutic use
  • Autonomic Nerve Block
  • Bone Density Conservation Agents / therapeutic use
  • Diagnosis, Differential
  • Diphosphonates / therapeutic use
  • Early Diagnosis
  • Free Radical Scavengers / therapeutic use
  • Glucocorticoids / therapeutic use
  • Humans
  • Occupational Therapy
  • Physical Therapy Modalities
  • Reflex Sympathetic Dystrophy / diagnosis*
  • Reflex Sympathetic Dystrophy / therapy*
  • Sympathectomy


  • Analgesics, Opioid
  • Anti-Inflammatory Agents, Non-Steroidal
  • Anticonvulsants
  • Bone Density Conservation Agents
  • Diphosphonates
  • Free Radical Scavengers
  • Glucocorticoids