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Aust Prescr
2015[Jun]; 38
(3
): 82-6
PMID26648626
show ga
Complex regional pain syndrome is an uncommon chronic pain condition. It develops
spontaneously or following an injury. The features are limb pain, allodynia,
hypersensitivity, hyperalgesia, abnormalities of the vasomotor, sudomotor and
motor systems, and trophic changes, with reduced use of the affected limb. The
diagnosis is clinical and one of exclusion. The emphasis of therapy is graded
rehabilitation and movement of the limb with physiotherapy and occupational
therapy. Psychological therapies should be offered if a patient is making no or
slow progress in the acute phase, and to all patients in the chronic phase as
depression can occur. The goal of pharmacotherapy is to assist functional
improvement. The early phase may be managed with simple analgesia.
Antineuropathic drugs including tricyclic antidepressants and antiepileptic drugs
may be added. Other treatments with some evidence of effectiveness include
corticosteroids, calcitonin and bisphosphonates. Vitamin C has been used for
primary prevention after wrist fracture and upper and lower limb surgery. There
is no evidence that it is effective for treating established complex regional
pain syndrome.
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