31st January 2024

CRPS

Prompt diagnosis and early treatment are best practice to avoid complications associated with disuse and the psychological consequences of living with undiagnosed chronic pain. Patients should receive education on the condition and be encouraged to use the limb. Patients should be informed that the pain associated with CRPS does not indicate tissue damage. Physiotherapy and occupational therapy input is considered first line treatment. Psychological therapies such as desensitisation therapy can also be used. In more complex cases, patients may be referred to rheumatology to confirm the diagnosis or to exclude the ongoing pathology, particularly after an operation. There is limited high-quality data for pharmacotherapy, and these should be started on an individual basis. Medications can include NSAIDs, neuropathic pain medications, and topical treatments such as lidocaine or capsaicin. In some cases, bisphosphonates can be used in CRPS if there is abnormal uptake on a bone scintigraphy scan. Referral to the pain team may also be beneficial.