What is the prognosis 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

RSD is rare in children, but it carries a much better prognosis in children than in adults. [26, 27]   Prognosis is also better with early institution of treatment.

A study by Bean and colleagues suggests that psychological factors may influence recovery from CRPS. In a prospective study of 66 patients with type 1 CRPS, those patients with lower anxiety and pain-related fear at baseline had the lowest pain intensity over the 12-month study period. These researchers proposed that those psychological variables could be considered as targets for early treatment. [28]

Royal College of Physicians guidelines list the following psychosocial risk factors (so-called yellow flags), which may be present initially or may develop during the course of treatment, and which may guide referral for more comprehensive care [11] :

  • Iatrogenic factors (ie previous negative experiences with health professionals)
  • Poor coping strategies (eg ongoing ‘guarding’ of the limb despite education)
  • Involvement in litigation/securing benefits (note that this may affect progress with treatment in some patients, but there must be no assumption that this applies in every patient)
  • Overuse of appliances
  • Distress
  • Anxiety/depression
  • Unwillingness to set goals
  • Passivity in treatment sessions
  • Inaccurate beliefs despite education
  • Fear avoidance
  • Negative family influences

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