Critical Reviews™ in Physical and Rehabilitation Medicine

The Multifaceted CRPS/RSD: Emerging Mechanisms and Therapy

ABSTRACT

Complex regional pain syndrome (CRPS), formerly known as reflex sympathetic dystrophy (RSD), is a debilitating pain syndrome that has been recognized for more than a century. Despite the long history of this disorder, both the natural course and the pathophysiology of CRPS have not been clearly determined. However, current research has begun to make inroads into unraveling the mechanisms of pathological pain, and it has helped to explain some aspects of CRPS. This article critically reviews current knowledge on pathogenesis and therapy of this debilitating disease. The first part of the review focuses on epidemiology, clinical manifestation and differential diagnosis of CRPS/RSD. Multiple triggers are discussed, as well as peripheral and central mechanisms of pain associated with CRPS/RSD. The second part of the article discusses in-depth conventional and emergent pharmacological treatments and outlines the available interventional and nonpharmacological approaches to patients with CRPS/RSD. A proposed treatment algorithm is offered.