Complex Regional Pain Syndrome
Complex Regional Pain Syndrome (CRPS) is established as a debilitating process that results in loss of function resulting in both reduced productivity and increased healthcare expenditures to treat this patient population. The pathophysiology of this disease is not well delineated, but it is thought to be a result of both peripheral and central nervous system hypersensitization often with autonomic dysregulation and increased expression of the inflammatory cascade. The amalgamation of chemical response likely involves localized inflammatory markers, central and peripheral neuropeptides, central neuroplasticity and inflammation, glial cell activation, and autoimmunity and predisposition to genetic up- and down-regulation. Given the known presentations of “warm” and “cold” CRPS, the treatment of this process is clinically challenging, and the stage of presentation of the disease often will dictate therapeutic direction.
