Complex Regional Pain Syndrome (CRPS)
Silas Weir Mitchell
First to describe causalgia
Definition
- neuropathic pain w/ sympathetic hyperactivity
Observations
- CRPS is more common in MS
- overdiagnosis, no biomarker
- most frequent inciting events are fractures and soft tissue injuries
Types CRPS
Type I (Sudeck atrophy or reflex sympathetic dystrophy): no proven nerve injury
Type II (causalgia): proven nerve injury
Budapest criteria
- Diagnosis requires: 1 Pain + 2/4 Signs + 3/4 Symptoms
- to support diagnosis use autonomic testing (skin temperature and sweating)
Stages
- acute, dystrophic, atrophic
Management
- psychological and behavioral
- pharmacological
> ibuprofen/naproxen + neuropathic pain agent + topical agent
- physiotherapy
- pain intervention