These are articles that give a general overview of the disease itself.
Complex Regional Pain Syndrome: a review
J. Field
Cheltenham General Hospital, Cheltenham, UK
AbstractComplex regional pain syndrome, formally known as reflex sympathetic dystrophy, is a poorly understood condition that describes a collection of clinical symptoms and signs occurring in the peripheries most commonly after trauma. Pain is the main problem. It is generally out of proportion to the degree of injury and can be unresponsive to narcotics. In addition joint stiffness, temperature and colour changes, and swelling occur. The diagnosis and treatment are challenging for any clinician and a multidisciplinary approach is often necessary with physiotherapy, occupational therapy, and the pain team. The hand surgeon is involved for two reasons, firstly as the upper limb is the most frequently involved, and secondly because the condition may be a complication of the patient’s surgery and result in a much prolonged recovery. This review elucidates the recent advances in the knowledge of the aetiology, classification and treatment of this fascinating condition.
Keywords
Complex regional pain syndrome, Reflex sympathetic dystrophy
Date received: 23rd June 2011; revised 15th November 2012; accepted 21st November 2012
Complex Regional Pain Syndrome: Practical Diagnostic and Treatment Guidelines,4th Edition
Published in Pain Medicine 2013
R. Norman Harden, MD,*§¶ Ann Louise Oaklander, MD, PhD,** Allen W. Burton, MD,††
Roberto S. G. M. Perez, RPT, PhD,***
Kathryn Richardson, MOTR,† Melanie Swan, OTR/L,‡‡ Jennifer Barthel, MS, CRC,‡
Brienne Costa, CTRS/R,§§ Joseph R. Graciosa, BA,* and Stephen Bruehl, PhD¶¶
Abstract
Objective. This is the fourth edition of diagno- stic and treatment guidelines for complex regi- onal pain syndrome (CRPS; aka reflex sympathetic dystrophy).
Methods. Expert practitioners in each discipline traditionally utilized in the treatment of CRPS systematically reviewed the available and relevant literature; due to the paucity of levels 1 and 2 studies, less rigorous, preliminary research reports were included. The literature review was supplemented with knowledge gained from extensive empirical clinical experience, particularly in areas where high quality evidence to guide therapy is lacking.
Results. The research quality, clinical relevance, and “state of the art” of diagnostic criteria or treatment modalities are discussed, sometimes in considerable detail with an eye to the expert practitioner in each therapeutic area. Levels of evidence are mentioned when available, so that the practitioner can better assess and analyze the modality under discussion, and if desired, to personally con- sider the citations. Tables provide details on characteristics of studies in different subject domains described in the literature.
Conclusions. In the humanitarian spirit of making the most of all current thinking in the area, balanced by a careful case-by-case analysis of the risk/cost vs benefit analysis, the authors offer these “practical” guidelines.