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Complex regional pain syndrome: an evolving perspective
  1. Steven Cutts1,
  2. Shafat Gangoo1,
  3. Sriram Harish Srinivasan1,
  4. Nitin Modi1,
  5. Chandra Pasapula2,
  6. Dominic Power3
  1. 1 Orthopaedics, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, UK
  2. 2 Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust, King’s Lynn, UK
  3. 3 Hand Surgery, UHN NHS FT, Birmingham, UK
  1. Correspondence to Steven Cutts, Orthopaedics, James Paget University Hospitals NHS Foundation Trust, Lowestoft Road, Gorleston On Sea, Great Yarmouth NR31 6LA, UK; stevenfrcs{at}


Background Complex regional pain syndrome (CRPS) is a heterogenous and poorly understood condition that can be provoked by quite minor injuries. The symptoms and signs of CRPS persist, long after the patient has recovered from the inciting event. In some cases, there is a clear association with a peripheral nerve injury. The degree of disability produced by CRPS is often out of proportion to the scale of the original insult and the condition is associated with protracted recovery times and frequent litigation.

Methods We have performed a PubMed literature search, referenced landmark papers in the field and included a national expert in peripheral nerve injury and repair in our team of authors.

Results and Conclusions The diagnostic criteria for CRPS have changed repeatedly over the last two centuries and much of the historical literature is difficult to compare with more recent research. In this review article, we consider how our understanding of the condition has evolved and discuss its pathogenesis, its apparent heterogenicity and the various investigations and treatments available to the clinician.

  • Basic sciences
  • pathology
  • internal medicine
  • neurology

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  • Contributors The paper was initiated and coordinated by the corresponding and first author, SC. DP as a recognised national authority in the field of peripheral nerve injury. He gave expert advice on the recent development in this area. SG, CP and SH and NM helped with the literature search and background studies for the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.