What is the role of surgical sympathectomy in the treatment of complex regional pain syndrome (CRPS)?

Updated: Jun 20, 2018
  • Author: Gaurav Gupta, MD; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Answer

Limited evidence is available regarding the efficacy of surgical sympathectomy. Four open-label studies have reported some long-lasting benefits in treating both CRPS types I and II. [144, 145, 146, 147] The most important factor in obtaining a positive outcome is having the procedure take place within 12 months of the inciting event. [144, 146] An irreversible sympathectomy may be effective in select cases owing to the risk of developing adaptive supersensitivity, even on nociceptive neurons, and having a subsequent increase and prolongation of pain. However, these procedures should not be widely recommended. [59]


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