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Síndrome de Dolor Regional Complejo (SDRC)

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What CRPS is, why it sometimes follows a wrist or hand injury or operation, how it is recognised and treated, and what recovery looks like.

Updated Oct 2026
Una mano con un suave halo que sugiere una sensibilidad aumentada.
En el SDRC, una extremidad puede volverse extremadamente dolorosa, hinchada y sensible, de forma desproporcionada respecto a la lesión original. Kieran Hirpara 4.0

Esta página se tradujo automáticamente y todavía no la ha revisado un médico. La versión en inglés es la versión oficial.

Qué está usted sintiendo

El síndrome de dolor regional complejo (SDRC) es una afección que causa un dolor intenso y duradero después de una lesión, a veces una lesión bastante leve. También puede oír que se le llama distrofia simpática refleja (DSR). El dolor suele ser desproporcionado respecto a la lesión original, y tiende a extenderse más allá de la zona lesionada. Junto con el dolor, puede notar cambios en la piel, hinchazón y que la mano o el brazo no funcionan como antes.

El dolor puede intensificarse por la noche y alterarle el sueño, y a menudo empeora después de la actividad. Las tareas cotidianas en las que usa la mano pueden volverse difíciles: agarrar un hervidor, girar una llave, escribir, abrocharse botones o cargar la compra. La afección puede influir en lo bien que se recupera la mano después de una fractura, como una fractura de muñeca, en cuánto tiempo pasa sin poder trabajar y en lo satisfecho que se siente con su recuperación.

No existe una única prueba que confirme el SDRC. Su médico establece el diagnóstico a partir de su historia clínica y de una exploración física, y solo después de haber descartado otras causas de su dolor. Esto es importante, porque algunas otras afecciones pueden parecerse y necesitan un tratamiento diferente.

Como el SDRC puede provocar una pérdida duradera de función si no se trata a tiempo, es importante reconocerlo pronto. Empezar el tratamiento cuanto antes le da la mejor oportunidad de que la mano y el brazo sigan funcionando.

Si la mano o el brazo se ponen calientes, rojos, hinchados y dolorosos, sobre todo si tiene fiebre, acuda al servicio de urgencias ese mismo día. No necesita una derivación de su médico de cabecera. Si los dedos o la mano se ponen pálidos, fríos, blancos o azules, o si pierde de repente la sensibilidad o el movimiento después de una lesión, acuda también al servicio de urgencias ese mismo día. Si sus síntomas no se calman, empeoran a lo largo de semanas, le despiertan por la noche o le impiden trabajar o usar la mano o el brazo, consulte a su médico de cabecera o solicite una evaluación con un especialista.

¿Qué está ocurriendo realmente?

El SDRC no es un problema de la articulación ni del propio hueso. Es un problema de los nervios que transmiten los mensajes de dolor y de la forma en que su cuerpo responde a una lesión.

Después de una lesión o una cirugía, el cuerpo normalmente emite una señal de alarma. La lesión se cura, la alarma se apaga y el dolor se calma. Con el SDRC, esa alarma sigue sonando mucho después de que el tejido se haya curado. Los nervios del brazo y de la mano se quedan activados, y el sistema del dolor se vuelve hipersensible, de modo que reacciona a cosas que no deberían doler. Los nervios que controlan el flujo sanguíneo y la sudoración también se ven afectados; por eso la piel puede cambiar de color, notarse caliente o fría e hincharse.

Por eso se producen los síntomas que acaba de leer. El dolor urente, la hinchazón y los cambios en la piel proceden de nervios que trabajan en exceso, no de un daño continuado en la zona de la lesión. El dolor es real, aunque la lesión original haya sido pequeña.

Puede que vea la afección descrita con distintos nombres. Antes, el SDRC se llamaba distrofia simpática refleja (DSR). Estos nombres describen el mismo problema, y la mezcla de términos a veces ha causado confusión.

No existe ningún análisis de sangre ni prueba de imagen que confirme el SDRC. Su médico determina si lo tiene a partir de su historia clínica y de una exploración física, después de comprobar que ninguna otra cosa está causando su dolor.

El SDRC no se debe a una única causa. Varios factores se combinan para desencadenarlo. Algunas personas tienen más probabilidades de desarrollarlo que otras, y tener previamente un problema nervioso en el mismo brazo puede aumentar el riesgo. Detectarlo pronto es importante, porque un tratamiento iniciado cuanto antes le da la mejor oportunidad de evitar una rigidez duradera y la pérdida de función de la mano.

Qué podemos hacer al respecto

Hay mucho que puede hacer usted mismo. Mantener la mano y el brazo en movimiento es la base del tratamiento, porque el reposo completo tiende a empeorar las cosas. La terapia ocupacional combinada con la fisioterapia ayuda a recuperar las actividades cotidianas que le importan, como vestirse, cocinar y escribir. A algunas personas también les resulta útil la terapia de espejo: usted observa en un espejo el reflejo de su mano sana en movimiento, lo que reentrena la forma en que el cerebro procesa el dolor. La terapia con láser de alta intensidad también puede reducir el dolor, a veces a partir de la tercera sesión de tratamiento. Dé a estos enfoques una oportunidad real durante varias semanas antes de juzgar si le están funcionando.

Los medicamentos pueden ayudar con el dolor mientras trabaja en el movimiento. Los analgésicos y los comprimidos antiinflamatorios pueden calmar las cosas lo suficiente para que pueda participar en la terapia. Un ciclo de comprimidos de corticoides (prednisolona) es otra opción que su médico puede considerar, sobre todo cuando es difícil acceder a tratamientos más especializados. Puede considerarse un medicamento llamado ketamina si su SDRC se ha vuelto duradero o no ha respondido a otros tratamientos. También existe una crema o pomada (doxepina) que se aplica sobre la piel. Tenga en cuenta que los medicamentos alivian el dolor, pero por sí solos no curan la afección, así que funcionan mejor junto con el movimiento y la terapia.

Si sus síntomas son intensos y siguen sin calmarse a pesar de todo lo anterior, su médico de cabecera o su médico pueden derivarle para una evaluación especializada. En algunas afecciones concretas, ocasionalmente puede considerarse un procedimiento.

Qué esperar

El SDRC evoluciona de forma distinta en cada persona. Algunas personas notan que sus síntomas se calman en semanas o meses con tratamiento. Otras tienen un dolor que aparece y desaparece, con buenas temporadas entre los brotes. Como la afección puede volverse duradera si no se trata a tiempo, cuanto antes empiece, mayores serán sus posibilidades de que la mano y el brazo sigan funcionando.

La recuperación suele notarse gradual más que repentina. Con un tratamiento bien llevado, la mayoría de las personas notan que primero se alivia el dolor urente, después se calma la hinchazón, y el movimiento y la fuerza vuelven a lo largo de semanas o meses. Puede que siga teniendo días en los que el dolor se intensifica después de la actividad, pero tienden a ser cada vez menos frecuentes. El objetivo es que vuelva a realizar tareas cotidianas como vestirse, cocinar y escribir.

Si el SDRC no se trata, puede provocar una rigidez duradera y la pérdida de función de la mano. Los analgésicos pueden aliviar el dolor, pero por sí solos no curan la afección. Por eso el movimiento y la terapia son el centro del tratamiento.

Hay noticias alentadoras sobre los problemas nerviosos subyacentes. La compresión nerviosa (un nervio apretado en el lugar donde pasa por un espacio estrecho) a menudo coexiste con el SDRC. Cuando hay pruebas claras de ello, tratarla puede acelerar su recuperación, y muchas personas con SDRC de tipo 1 ven desaparecer por completo sus síntomas una vez que se libera la compresión.

¿Cuándo consultar a un especialista?

La mayoría de los signos de alarma del SDRC ya se han explicado antes en esta página, y aquí se aplican las mismas pautas. Acuda al servicio de urgencias ese mismo día si la mano o el brazo se ponen calientes, rojos, hinchados y dolorosos, sobre todo si tiene fiebre, o si los dedos o la mano se ponen pálidos, fríos, blancos o azules, o si pierde de repente la sensibilidad o el movimiento después de una lesión. Consulte a su médico de cabecera o solicite una evaluación con un especialista si sus síntomas no se calman, empeoran a lo largo de semanas, le despiertan por la noche o le impiden trabajar o usar la mano o el brazo. Si no puede contactar con la clínica, acuda al servicio de urgencias más cercano.

Hay otros dos aspectos que conviene conocer. El SDRC se diagnostica a partir de su historia clínica y de la exploración, porque ninguna prueba puede confirmarlo ni descartarlo. Y como algunas otras afecciones pueden imitarlo, su médico solo lo considerará SDRC después de comprobar si hay otras causas de su dolor.

Reviewed by Kieran Hirpara · 13 June 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Complex regional pain syndrome (CRPS) is a clinical syndrome characterized by pain, autonomic dysfunction, trophic changes, and functional impairment [1].
  • CRPS is a multifactorial condition that requires further study to better understand its pathogenesis, epidemiology, genetic involvement, psychological implications, and treatment options [8].
  • The terms reflex sympathetic dystrophy (RSD), sympathetically maintained pain (SMP), and complex regional pain syndrome (CRPS) have often been used synonymously, which leads to misunderstanding and misdiagnosis [13].
  • The diagnosis of CRPS is made primarily on a clinical basis based on history and physical examination [2, 14].
  • No specific test is known to confirm or exclude a diagnosis of CRPS [2].
  • Quantitative sensory testing outcomes indicate altered pain mechanisms in CRPS compared to controls, with a pooled standardized mean difference of -0.41 [10].
  • The Hamilton Inventory can be relied upon to assess CRPS symptoms, functional limitations, and psychosocial impacts [9].
  • Early recognition and prompt treatment of CRPS are important to minimize permanent loss of function, though patients may still experience permanent impairment and disability [14].
  • CRPS is a severe and disabling condition that often follows a minor injury [11].
  • Chronic pain from CRPS or RSD of the foot and ankle presents diagnostic and therapeutic challenges to the foot and ankle surgeon [3].
  • The reported incidence of CRPS is influenced by the choice of diagnostic criteria, study location, and how the fracture is managed [44].
  • The overall 1-year incidence rate of CRPS following isolated cubital tunnel surgery is approximately 0.33% [15].
  • It is very difficult to reach definitive conclusions regarding the risk factors for, the prevention of, and the recurrence of CRPS [20].
  • A more active treatment approach for distal radius fracture seems to lower the incidence of CRPS-1 [16].
  • A well-established referral system and knowledge of CRPS I in the multidisciplinary team seem to reduce the incidence of CRPS I in patients with hand injury and after hand surgery [26].
  • Following patients closely for the development of CRPS I may be advantageous for early preventative and therapeutic interventions [6].
  • The recurrence rate of CRPS fell significantly from 72% to 10% when a stellate ganglion block was performed in patients with a history of CRPS undergoing surgery on the affected upper extremity [12].
  • Traditionally, surgical treatment has been avoided in patients with CRPS; however, in the setting of clinical and electrophysiologic evidence of nerve compression, surgical intervention may hasten recovery [5].

Background & Causes

  • The terms reflex sympathetic dystrophy (RSD), sympathetically maintained pain (SMP), and complex regional pain syndrome (CRPS) have often been used synonymously, leading to misunderstanding and misdiagnosis [13].
  • The diagnosis of CRPS is made primarily on a clinical basis, and no specific test is known to confirm or exclude the diagnosis [2].
  • The diagnosis of CRPS is based on history and physical examination [14].
  • Early recognition and prompt treatment are important to minimize permanent loss of function, though patients may still experience permanent impairment and disability [14].
  • The peripheral pathophysiology involves a prolonged inflammatory response to injury due to the axon reflex with release of vasoactive neuropeptides and sensitized nociceptors [32].
  • In RSD patients, sympathetic nervous system function is altered and differs in the various stages [33].
  • Interactions between the neuroendocrine and immune systems should be considered when planning research into pathological pain states [35].
  • Quantitative sensory testing outcomes indicate altered pain mechanisms in complex regional pain syndrome compared to controls, with a pooled standardized mean difference of -0.41 [10].
  • Reflex sympathetic dystrophy is a pain syndrome characterized by pain, decreased joint motion, vasomotor and trophic changes, and a favorable response to sympathetic blockade [27].
  • Preexisting neuropathic disorders, particularly traumatic nerve injuries, compressive neuropathies, and cervical radiculopathy, are the strongest predictors of CRPS after distal radius fracture [30].
  • A pre-existing diagnosis of fibromyalgia was independently associated with CRPS at 3-months (OR 2.42) and 1-year (OR 1.73) [31].
  • Female sex and release of more than one digit are significant predictors of developing CRPS following treatment of Dupuytren contracture [19].
  • Elderly patients, females, and manual laborers have higher risks for the occurrence of CRPS after distal radius fracture surgery [47].
  • Patients who developed CRPS Type 1 after radial forearm fracture had neither a unique psychological pattern nor displayed more symptoms of depression than those who recovered uneventfully [22].
  • A more active treatment approach seems to lower the incidence of CRPS-1 following distal radius fracture [16].
  • 30 of the 35 (86%) patients with RSD in a specific study were shown to have one or more nerve entrapments in the affected limb [24].

Symptoms & Presentation

  • CRPS is a multifactorial condition [8].
  • CRPS 1 is a severe and disabling condition often following a minor injury [11].
  • Chronic pain from complex regional pain syndrome (CRPS) or reflex sympathetic dystrophy (RSD) of the foot and ankle presents diagnostic and therapeutic challenges to the foot and ankle surgeon [3].
  • The terms reflex sympathetic dystrophy (RSD), sympathetically maintained pain (SMP), and complex regional pain syndrome (CRPS) have too often been used synonymously, leading to misunderstanding and misdiagnosis [13].
  • Glomus tumors should be included in the differential diagnosis for patients with unusual chronic pain or neuropathy, and the diagnosis of CRPS should only be a diagnosis of exclusion [43].

Management

Diagnosis and Assessment

  • The diagnosis of CRPS is made primarily on a clinical basis [2].
  • No specific test is known to confirm or exclude a CRPS diagnosis [2].
  • Early recognition and prompt treatment are important to minimize permanent loss of function [14].
  • Patients with CRPS may still experience permanent impairment and disability despite early treatment [14].

Risk Factors and Prevention

  • Female sex is a significant predictor of developing CRPS following treatment of Dupuytren contracture [19].
  • Release of more than one digit is a significant predictor of developing CRPS following treatment of Dupuytren contracture [19].
  • Close follow-up of patients with distal radius fractures may be advantageous for early preventative and therapeutic interventions for CRPS I [6].
  • CRPS following isolated cubital tunnel surgery is exceedingly rare, with an overall 1-year incidence rate of approximately 0.33% [15].

Non-Operative Management

  • In patients presenting with chronic or refractory CRPS, strong consideration should be given for the use of ketamine [4].
  • Prednisolone is a potential treatment option for CRPS, particularly in resource-limited settings where more specialized interventions may be unavailable [17].
  • High-intensity laser therapy and mirror therapy offer conclusive evidence of pain reduction in CRPS-I, even after the third HILT treatment session [18].
  • Occupational therapy combined with physical therapy brings a real benefit in restoring essential activities of daily life in CRPS [37].
  • Hypnotherapy combined with physical therapy appears to be an effective treatment strategy for CRPS-1 in the hand and wrist, regardless of disease stage [41].
  • Thermal self-regulation was effective as a pain reduction strategy for patients with reflex sympathetic dystrophy syndrome who had failed to benefit from other treatments [34].
  • Continuous cervical epidurals may deserve prospective evaluation as a potentially viable treatment option for advanced upper extremity reflex sympathetic dystrophy in combination with physical therapy and other conventional therapeutic regimens [38].
  • Topical application of doxepin may represent a simple option for the management of CRPS [42].
  • The methodological quality of non-pharmacological treatment approaches for upper limb CRPS is overall poor [25].
  • Analgesic treatments for CRPS-I have good analgesic effects but do not cure the condition [7].

Operative Management

  • Traditionally, surgical treatment has been avoided in patients with complex regional pain syndrome [5].
  • In the setting of clinical and electrophysiologic evidence of nerve compression, surgical intervention may hasten recovery in patients with CRPS [5].
  • Compression syndromes coexist with reflex sympathetic dystrophy (RSD) and must be treated to best deal with RSD [28].
  • A large percentage of patients diagnosed with and treated for CRPS type 1 can have full resolution of their symptoms with carpal tunnel release [21].
  • The recurrence rate of CRPS fell significantly from 72% to 10% when a stellate ganglion block was performed in patients undergoing surgery on the affected upper extremity [12].
  • Subclavian vein release is a surgical management option for resistant complex regional pain syndrome type 1 (CRPS 1) [11].

Key Considerations

Diagnosis and Pathophysiology

Risk Factors and Incidence

  • CRPS is common after hand trauma or surgery [1].
  • CRPS-related hand lesions developed in 19.4% of patients following arthroscopic rotator cuff repair [23].
  • A pre-existing diagnosis of fibromyalgia was independently associated with CRPS at 3-months (OR 2.42) and 1-year (OR 1.73) following distal radius fracture [31].
  • A well-established referral system and knowledge of CRPS I in the multidisciplinary team seems to reduce the incidence of CRPS I in patients with hand injury and after hand surgery [26].

Treatment Considerations

  • Analgesics, despite their good analgesic effects, do not cure CRPS-I [7].
  • High-intensity laser therapy and mirror therapy offer conclusive evidence of pain reduction in CRPS-I, even after the third treatment session [18].
  • Traditionally surgical treatment has been avoided in patients with complex regional pain syndrome; however, in the setting of clinical and electrophysiologic evidence of nerve compression, surgical intervention may hasten recovery [5].
  • 30 of the 35 (86%) patients with RSD in a study were shown to have one or more nerve entrapments in the affected limb [24].
  • The early and complete resolution of symptoms in all five patients in a study implies that continued nerve compression or irritation was not the significant problem, suggesting psychological factors or peripheral sympathetic hyperreactivity were predominant [48].

Key Evidence

  • [Paper] Complex regional pain syndrome (CRPS) is a clinical syndrome of pain, autonomic dysfunction, trophic changes, and functional impairment that is common after hand trauma or surgery. [1] (10.1197/j.jht.2005.02.005)
  • [Paper] 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. [2] (10.1142/s2424835518300013)
  • [L5] Chronic pain from complex regional pain syndrome (CRPS) or reflex sympathetic dystrophy (RSD) of the foot and ankle presents a myriad of diagnostic and therapeutic challenges to the foot and ankle surgeon. [3] (10.1016/s0278-5919(03)00090-5)
  • [L1] In patients presenting with chronic or refractory CRPS, strong consideration should be given for the use of ketamine. [4] (10.1177/15589447221131847)
  • [L4] Traditionally surgical treatment has been avoided in patients with complex regional pain syndrome; however, in the setting of clinical and electrophysiologic evidence of nerve compression surgical intervention may hasten recovery in these patients. [5] (10.1016/j.jhsa.2004.08.006)
  • [L3] To following these patients closely for the development of CRPS I may be advantageous for early preventative and therapeutic interventions. [6] (10.1142/s2424835518500571)
  • [L5] The latter, despite their good analgesic effects, do not cure CRPS-I. [7] (10.1016/j.main.2013.07.011)
  • [L4] CRPS is a multifactorial condition that still requires further studying to better understand its pathogenesis, epidemiology, genetic involvement, psychological implications, and treatment options. [8] (10.1007/s40122-021-00279-4)
  • [L4] It can be relied upon to assess CRPS symptoms, functional limitations, and psychosocial impacts. [9] (10.1016/j.jht.2025.02.004)
  • [L1] The systematic review and meta-analysis of quantitative sensory testing outcomes indicates altered pain mechanisms in complex regional pain syndrome compared to controls, with a pooled standardized mean difference of -0.41. [10] (10.1186/s13018-022-03461-2)
  • [L4] CRPS 1 is a severe and disabling condition often following by a minor injury. [11] (10.1016/s0363-5023(03)80425-2)
  • [L3] The recurrence rate of CRPS fell significantly from 72% to 10% when a stellate ganglion block was performed in this patient population. [12] (10.1053/jhsu.2000.18496)
  • [L5] The terms reflex sympathetic dystrophy (RSD), sympathetically maintained pain (SMP), and complex regional pain syndrome (CRPS) have too often been used synonymously, leading to misunderstanding and misdiagnosis. [13] (10.1016/s0894-1130(00)80017-4)
  • [L2] CRPS following isolated CuTS is exceedingly rare, with an overall 1-year incidence rate of approximately 0.33%. [15] (10.1016/j.jhsg.2026.101028)
  • [L3] A more active treatment approach seems to lower the incidence of CRPS-1. [16] (10.1177/1558944719895782)
  • [L4] The report emphasizes the importance of recognizing CRPS and highlights the potential of prednisolone as a treatment option, particularly in resource-limited settings where more specialized interventions may be unavailable. [17] (10.1186/s12891-024-07333-0)
  • [L1] The study results offer conclusive evidence of pain reduction, a highly debilitating symptom in CRPS-I, even after the third HILT treatment session. [18] (10.1016/j.jht.2025.02.009)
  • [L3] Female sex and release of more than one digit are significant predictors of developing CRPS. [19] (10.1177/1558944720963915)
  • [L5] It is very difficult to reach any definitive conclusions regarding the risk factors for, the prevention of, and the recurrence of CRPS. [20] (10.1016/j.jhsb.2004.01.003)
  • [L3] This study demonstrates that a large percentage of patients diagnosed with and treated for CRPS type 1 can have full resolution of their symptoms with carpal tunnel release. [21] (10.1016/j.jhsa.2024.09.024)
  • [L2] Therefore, patients who eventually developed CRPS Type 1 after radial forearm fracture had neither a unique psychological pattern nor displayed more symptoms of depression than those who recovered uneventfully. [22] (10.1016/j.jhsb.2005.06.023)
  • [L3] CRPS-related hand lesions developed in 19.4% of patients following ARCR. [23] (10.5397/cise.2021.00080)
  • [L4] 30 of the 35 (86%) patients with RSD in this study were shown to have one or more nerve entrapments in the affected limb. [24] (10.1016/0266-7681(93)90057-m)
  • [L1] Methodological quality of non-pharmacological treatment approaches for upper limb CRPS is overall poor. [25] (10.1177/17589983221138610)
  • [L4] A well-established referral system and knowledge of CRPS I in the multidisciplinary team seems to reduce the incidence of CRPS I in patients with hand injury and after hand surgery. [26] (10.1177/1558944716660555km)
  • [L4] Reflex sympathetic dystrophy is a pain syndrome characterized by pain, decreased joint motion, vasomotor and trophic changes, and a favorable response to sympathetic blockade. [27] (10.1016/s0363-5023(83)80006-9)
  • [L4] Compression syndromes coexist with reflex sympathetic dystrophy (RSD) and must be treated to best deal with RSD. [28] (10.1016/0363-5023(91)90202-m)
  • [L3] Preexisting neuropathic disorders, particularly traumatic nerve injuries, compressive neuropathies, and cervical radiculopathy, are the strongest predictors of CRPS after distal radius fracture. [30] (10.1016/j.jhsa.2026.01.004)
  • [L3] A pre-existing diagnosis of fibromyalgia was independently associated with CRPS at 3-months (OR 2.42) and 1-year (OR 1.73). [31] (10.1016/j.injury.2026.113140)
  • [L5] The peripheral pathophysiology involves a prolonged inflammatory response to injury due to the axon reflex with release of vasoactive neuropeptides and sensitized nociceptors. [32] (10.1016/s0894-1130(97)80068-3)
  • [L4] These results suggest that in RSD patients the sympathetic nervous system function is altered and is different in the various stages. [33] (10.1016/s0266-7681(97)80031-9)
  • [L4] This intervention was effective as a pain reduction strategy for our patients with reflex sympathetic dystrophy syndrome who had failed to benefit from other treatments. [34] (10.1016/s0363-5023(09)90024-7)
  • [L4] Interactions between the neuroendocrine and immune systems should be considered when planning research into pathological pain states. [35] (10.1016/s0266-7681(98)80162-9)
  • [L3] In CRPS, OT combined with PT brings a real benefit in restoring the essential activities of daily life. [37] (10.1016/j.hansur.2016.06.005)
  • [L4] Continuous cervical epidurals may deserve prospective evaluation as a potentially viable treatment option for advanced upper extremity reflex sympathetic dystrophy in combination with physical therapy and other conventional therapeutic regimens. [38] (10.1016/s0363-5023(05)80296-5)
  • [L4] Hypnotherapy combined with physical therapy appears to be an effective treatment strategy for CRPS-1 in the hand and wrist, no matter the disease stage. [41] (10.1016/j.hansur.2016.12.008)
  • [L5] This case report suggests that the topical application of doxepin may represent a simple option for the management of CRPS. [42] (10.1016/s0020-1383(01)00054-7)
  • [Case_report] Glomus tumors should be included in the differential diagnosis for patients with unusual chronic pain or neuropathy, and the diagnosis of CRPS should only be a diagnosis of exclusion. [43] (10.1177/1558944719895618)
  • [L1] The reported incidence of CRPS is influenced by choice of diagnostic criteria, along with the study location and/or how the fracture is managed. [44] (10.1177/1758998320910179)
  • [L3] The occurrence of CRPS is the result of many factors, with elderly patients, females, and manual laborers having higher risks. [47] (10.1186/s12891-024-07948-3)
  • [L5] The early and complete resolution of symptoms in all five of their patients implies that continued nerve compression or irritation was not the significant problem, suggesting psychological factors or peripheral sympathetic hyperreactivity were predominant. [48] (10.1016/s0363-5023(80)80021-9)

References

[1] Diagnosis and Management of Complex Regional Pain Syndrome Complicating Upper Extremity Recovery. Journal of Hand Therapy. 2005. DOI: 10.1197/j.jht.2005.02.005

[2] Complex Regional Pain Syndrome Type 1: Diagnosis and Management. The Journal of Hand Surgery (Asian-Pacific Volume). 2018. DOI: 10.1142/s2424835518300013

[3] Complex regional pain syndrome (reflex sympathetic dystrophy). Clinics in Sports Medicine. 2004. DOI: 10.1016/s0278-5919(03)00090-5

[4] Pharmacologic Treatments in Upper Extremity Complex Regional Pain Syndrome: A Review and Analysis of Quality of Evidence. HAND. 2022. DOI: 10.1177/15589447221131847

[5] Nerve decompression for complex regional pain syndrome type II following upper extremity surgery. The Journal of Hand Surgery. 2005. DOI: 10.1016/j.jhsa.2004.08.006

[6] Investigate the Effect of Psychological Factors in Development of Complex Regional Pain Syndrome Type I in Patients with Fracture of the Distal Radius: A Prospective Study. The Journal of Hand Surgery (Asian-Pacific Volume). 2018. DOI: 10.1142/s2424835518500571

[7] Type I complex regional pain syndrome. Chirurgie de la Main. 2013. DOI: 10.1016/j.main.2013.07.011

[8] Complex Regional Pain Syndrome: A Comprehensive Review. Pain and Therapy. 2021. DOI: 10.1007/s40122-021-00279-4

[9] Psychometric evaluation of the Hamilton Inventory to evaluate signs and symptoms in patients with Complex Regional Pain Syndrome (CRPS). Journal of Hand Therapy. 2025. DOI: 10.1016/j.jht.2025.02.004

[10] Pain mechanisms in complex regional pain syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes. Journal of Orthopaedic Surgery and Research. 2023. DOI: 10.1186/s13018-022-03461-2

[11] The surgical management of resistant complex regional pain syndrome type 1 (CRPS 1) (reflex sympathetic dystrophy) by subclavian vein release. The Journal of Hand Surgery. 2003. DOI: 10.1016/s0363-5023(03)80425-2

[12] Surgery on the affected upper extremity of patients with a history of complex regional pain syndrome: A retrospective study of 100 patients. The Journal of Hand Surgery. 2000. DOI: 10.1053/jhsu.2000.18496

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