What causes complex regional pain syndrome (CRPS)?

Updated: Nov 08, 2018
  • Author: Steven J Parrillo, DO, FACOEP, FACEP; Chief Editor: Andrew K Chang, MD, MS  more...
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Many hypotheses exist, but a definite cause has not been identified. (See Pathophysiology).

Older literature suggested that development of complex regional pain syndrome (CRPS) required a triad of conditions: an injury, an abnormal sympathetic response, and a predisposing personality. Most current literature disputes the need for an underlying personality disorder. In August 2000, Schwartzman stated, "There is no evidence that affected patients have a personality disorder, but the severity of pain and the disruption of the patient's life can lead to anxiety and depression." [31] Beerthuizen et al reviewed 31 articles that addressed an association between psychiatric illness and CRPS-1. Almost all the studies showed no causal relationship. [32]

Peterlin et al suggested that migraine may be a risk factor for the development of CRPS, but theirs is the only paper of its type. [33]

ACE inhibitors have been suggested as a possible cause for the development of CRPS. [12, 34]

Evidence now shows that CRPS may have a genetic predisposition. [7, 8]

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