What are the treatment guidelines for complex regional pain syndrome (CRPS 1) (RSD)?

Updated: Sep 09, 2018
  • Author: T P Sudha Rao, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

United Kingdom guidelines on complex regional pain syndrome (CRPS) list four ‘pillars’ of CRPS care: education, pain relief (medication and procedures), physical rehabilitation, and psychological intervention. All four are of equal importance, and addressing them may require involvement of a range of specialties, such as physiotherapy, pain medicine, rheumatology, neurology, and surgery. [11]

International guidelines for the management of CRP, sponsored by the Reflex Sympathetic Dystrophy Syndrome Association (RSDSA) and most recently updated in 2014, acknowledge the paucity of high-level studies, and thus base the recommendations on literature review supplemented with clinical expertise. The guidelines include a treatment algorithm focused on functional restoration provided by an interdisciplinary team (eg, occupational, physical, recreational therapist; vocational rehabilitation counselor). [10]

In addition, the guidelines recommend providing access to medications, psychotherapy, and/or injections from the start of treatment, if needed and appropriate. If the patient cannot begin treatment or fails to progress with treatment at any step or in any regard, consideration should be given to starting or adding more or stronger medication, more intensive psychotherapies, and/or different interventions.


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