Which medications are used in the treatment of complex regional pain syndrome type 1 (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

Indications for pharmacotherapy and suggested choices include the following [10] :

  • Mild-to-moderate pain – Simple analgesics and/or blocks
  • Excruciating, intractable pain – Opioids and/or blocks or later, more experimental interventions
  • Inflammation/swelling and edema – Steroids, systemic or targeted (for acute treatment) or nonsteroidal anti-inflammatory drugs (for long-term treatment); immune modulators
  • Depression, anxiety, insomnia – Sedative, analgesic antidepressant/anxiolytics (and/or psychotherapy)
  • Significant allodynia/hyperalgesia – Anticonvulsants and/or other sodium channel blockers and/or N-methyl-D-aspartate (NMDA) receptor antagonists (eg, ketamine)
  • Significant osteopenia, immobility and trophic changes – Calcitonin or bisphosphonates
  • Profound vasomotor disturbance – Calcium channel blockers, sympatholytics,, and/or blocks

Virtual reality is increasingly under study for treatment of CRPS. This approach expands on principles of mirror therapy, and appears to provide reduction in pain and increase in function. [12, 13]

For information on physical medicine approaches to CRPS, see Physical Medicine and Rehabilitation for Complex Regional Pain Syndromes.


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