Review of CRPS Management
Date: 05th August 2026 | By: Dr Lourdes Gaspar
WHO ICD-11 definition of CRPS, which describes it as a chronic pain condition that typically develops after tissue trauma, involves ongoing pain disproportionate to the injury, and is frequently associated with emotional distress and functional disability
Key Takeaways of this review:
1. CRPS remains a clinical diagnosis
CRPS typically develops after fractures, surgery, nerve injury, or other limb trauma.
Diagnosis primarily on the Budapest Criteria – most widely used diagnostic criteria.
Imaging and diagnostic tests are helpful mainly to rule out other conditions, rather than confirm CRPS.
2. Early diagnosis matters
Delayed recognition can lead to chronic pain, disability, stiffness, loss of function, and poorer outcomes.
Surgeons should maintain a high index of suspicion when pain is disproportionate to the expected recovery pathway.
3. Rehabilitation is the cornerstone of treatment. The strongest message from the review is that treatment should be:
Function-focused
Multidisciplinary
Started early
Core interventions include:
Patient education
Desensitization techniques
Edema management
Graded exercise and movement
Occupational and physical therapy
The goal is not simply pain reduction, but restoring meaningful hand and upper extremity function.
4. Medications can support recovery. Evidence supports selective use of:
Corticosteroids (especially early stages)
Bisphosphonates
Neuropathic pain medications
Certain intravenous therapies
However, no medication consistently works for all patients. Drug treatments should facilitate participation in rehabilitation rather than replace it.
5. Interventional treatments have a role. For persistent or refractory cases:
Sympathetic nerve blocks
Ketamine infusions
Spinal cord stimulation (SCS)
Dorsal root ganglion (DRG) stimulation
These may reduce symptoms and improve function but considered after conservative treatments.
Clinical Bottom Line
The review concludes that CRPS management should follow a staged, multidisciplinary pathway where the primary objective is functional restoration rather than pain elimination alone. Rehabilitation should begin as early as possible, with medications and procedures used to enable movement, participation, and recovery.
At ACTforPAIN , this aligns closely with our biopsychosocial and rehabilitation-focused approach. We know that people living with persistent pain are more than their symptoms, and meaningful recovery often starts with helping individuals reconnect with valued activities, movement, work, and life.
The goal isn’t just less pain. It’s more life.
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