COMPLEX REGIONAL PAIN SYNDROME (REFLEX SYMPATHETIC DYSTROPHY AND CAUSALGIA)
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Complex regional pain syndrome (CRPS) type I is a regional pain syndrome that usually develops after tissue trauma. Allodynia (the perception of a nonpainful stimulus as painful), hyperpathia (an exaggerated pain response to a painful stimulus), and spontaneous pain occur. Symptoms are unrelated to the severity of the initial trauma and are not confined to the distribution of a single peripheral nerve. CRPS type II is a regional pain syndrome that develops after injury to a peripheral nerve, usually a major nerve trunk. Spontaneous pain initially develops within the territory of the affected nerve but eventually may spread outside the nerve distribution.
- Early mobilization with physical therapy or a brief course of glucocorticoids may be helpful for CRPS type I.
- Other treatments include the use of adrenergic blockers, NSAIDs, calcium channel blockers, phenytoin, opioids, and calcitonin.
- Stellate ganglion blockade is a commonly used invasive therapeutic technique that often provides temporary pain relief, but the efficacy of repetitive blocks is uncertain.