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Understanding the Pharmacologic Therapy for Patients Afflicted With Complex Regional Pain Syndrome
U.S. Pharmacist, 05/22/09

Brenton-Wood B - Complex regional pain syndrome, previously known as reflex sympathetic dystrophy, is a syndrome that typically affects one or more extremities but may affect any part of the body...If left untreated, CRPS can result in permanent deformities and chronic pain requiring a range of long-term pharmacologic and nonpharmacologic treatments. If the condition is caught early, physical therapy is a valuable tool to mobilize the affected body part, and sympathetic nerve blocks may be used to stop the progression of or cure the disease. Other therapies used to treat patients with CRPS are psychotherapy, surgical sympathectomy, spinal cord stimulation, and intrathecal drug pumps. The absence of well-defined criteria for the diagnosis of this syndrome has resulted in a lack of RCTs for the treatment of CRPS. In some of the cases, data have only been reported on posters during clinical meetings. The medications that have been used or tried in this population include certain antidepressants, anticonvulsants, anesthetics, antihypertensives, anti-inflammatories, opioids, calcitonin, bisphosphonates, and neuropathic coanalgesics, among others. There are no medications that are FDA approved for the treatment of CRPS. To avoid polypharmacy, it is important to remove agents from the regimen that are not resulting in an improvement in pain or function.

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