What is the role of surgery 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

Surgical sympathectomy is only likely to provide complete pain relief for patients demonstrating transient complete relief with paravertebral sympathetic ganglion blockade.

  • The reported incidence of complete relief ranged from 58-100% and the duration of follow-up varied from 6 months to 17 years in the studies performed.

  • Surgical sympathectomy should not be recommended routinely because the SMP component may resolve spontaneously over time or play a minimal role, if any, in the complicated pathogenesis of CRPS.

  • Some patients who experience complete relief for a while have a relapse.

Amputation of the affected limb as a treatment is an extreme option that is very rarely recommended. In the past, it was sometimes used with patients who had CRPS with severe hyperpathia in combination with a limb that was either nonfunctional or had severe recurrent infections. However, there is a significant risk of CRPS then developing in the stump.


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