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Complex Regional Pain Syndrome
(CRPS; Reflex Sympathetic Dystrophy [RSD]; Causalgia; Sympathetically Maintained Pain)
by Debra Wood, RN
Complex regional pain syndrome (CRPS) refers to a chronic condition that affects the nerves and blood vessels of 1 or more limbs.
There are 2 types of CRPS:
The cause of CRPS is not known. The condition likely results from several factors. It may involve overactivity of the sympathetic nervous system. Inflammation may also play a role in the disorder.
Risk Factors TOP
Factors that may increase your risk of CRPS include:
Symptoms usually appear after an injury. The most important symptom of CPRS is prolonged pain that may be constant or severe. Pain is typically described as burning, throbbing, aching, squeezing, or shooting.
Symptoms of CRPS change over time and may include:
You will be asked about your symptoms and medical history. A physical exam will be done. You may be referred to a pain specialist.
Images may be taken of your bodily structures. This can be done with:
The electrical activity in your nerves and muscles may need to be tested. This can be done with:
You may need to have your body's heat measured. This can be done with a thermogram.
You may need to have your autonomic nervous system evaluated. This can be done with quantitative sudomotor axon reflex test (QSART), resting sweat output (RSO), or the resting skin temperature (RST).
Treatment aims to relieve pain and improve function. Early therapy may lead to better outcomes. In some cases, the condition goes away on its own; this is more common in children. Talk with your doctor about the best treatment plan for you. Options include:
Physical and Occupational Therapy
Physical and occupational therapy may help reduce pain and increase mobility.
Cognitive behavioral therapy may help you manage pain. It is a form of talk therapy that focuses on how the way you think affects the way you feel and act.
Your doctor may advise the following medications:
A surgical procedure called sympathectomy can permanently destroy sympathetic nerves. In some cases however, surgery may worsen symptoms.
Other Treatments TOP
A device may be implanted in your spine. It will deliver electric stimulus to your spinal cord to manage pain.
There are no known ways to prevent CRPS.
International Research Foundation for RSD/CRPS
Reflex Sympathetic Dystrophy Syndrome Association
Complex regional pain syndrome (CRPS). EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated April 11, 2016. Accessed June 20, 2016.
Complex regional pain syndrome fact sheet. National Institute of Neurological Disorders and Stroke website. Available at:
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Updated November 3, 2015. Accessed June 20, 2016.
Harden RN, Bruehl SP. Diagnosis of complex regional pain syndrome: signs, symptoms, and new empirically derived diagnostic criteria. Clinical Journal of Pain. 2006;22:415-419.
8/10/2007 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Zollinger PE, Tuinebreijer WE, Breederveld RS, Kreis RW. Can vitamin C prevent complex regional pain syndrome in patients with wrist fractures? A randomized, controlled, multicenter dose-response study. J Bone Joint Surg Am. 2007;89:1424-1431.
11/9/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Cacchio A, DeBlasis, E, Necozione S, di Orio F, Santilla V. Mirror therapy for chronic complex regional pain syndrome type 1 and stroke. N Engl J Med. 2009;361(6):634-636.
4/24/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Wise JN, Weissman BN, et al. American College of Radiology (ACR) Appropriateness Criteria for chronic foot pain. Available at:
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Updated 2013. Accessed June 4, 2015.
Last reviewed June 2016 by Marcin Chwistek, MD
Last Updated: 6/18/2014
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