eMedicine Specialties > Emergency Medicine > Neurology

Complex Regional Pain Syndrome: Follow-up

Author: Steven J Parrillo, DO, FACOEP, FACEP, Associate Professor, Emergency Medicine, Jefferson Medical College and Philadelphia College of Osteopathic Medicine; Medical Director, Department of Emergency Medicine, Einstein Elkins Park; Chair, Emergency Management Committee, Albert Einstein Healthcare Network; Medical Director, Disaster Medicine and Management Masters Program, Philadelphia University
Contributor Information and Disclosures

Updated: Oct 26, 2009

Follow-up

Further Inpatient Care

Although not FDA approved in the United States, in some countries, patients with complex regional pain syndrome are hospitalized and placed on continuous intravenous infusions of medications such as lidocaine or ketamine. As a dissociative anesthetic, the latter is intended to "erase" the memory of dysfunctioning neurons. Results have been variable.

Further Outpatient Care

It is in the best interest of patients with complex regional pain syndrome (CRPS) to have a physician knowledgeable about this entity orchestrate all care. Appropriate referral is important.

Deterrence/Prevention

It has been well documented that those with complex regional pain syndrome who are diagnosed earliest do the best. Once the disease is well established, it probably cannot be reversed.

Complications

Once refractory to neural blockade, pain is probably lifelong and may be severe enough to be debilitating.

Prognosis

Prognosis of complex regional pain syndrome depends largely on timely diagnosis and use of early aggressive therapy.

Patient Education

Patients should be encouraged to seek out CRPS support groups.

Miscellaneous

Medicolegal Pitfalls

  • Because many clinicians are not aware of complex regional pain syndrome (CRPS), the possibility of misdiagnosis or late diagnosis with consequent poor outcome exists.
  • Individuals with CRPS/RSDS may depend on potent analgesia to control pain. Do not assume that they are illegitimate drug seekers.
 


More on Complex Regional Pain Syndrome

Overview: Complex Regional Pain Syndrome
Differential Diagnoses & Workup: Complex Regional Pain Syndrome
Treatment & Medication: Complex Regional Pain Syndrome
Follow-up: Complex Regional Pain Syndrome
References
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References

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Further Reading

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Keywords

complex regional pain syndrome symptoms, complex regional pain syndrome treatment, RSDS, RSD, reflex sympathetic dystrophy syndrome, causalgia, sympathetic maintained pain syndrome, complex regional pain syndrome, CRPS, CRPS I, CRPS II, peripheral nerve injury

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Contributor Information and Disclosures

Author

Steven J Parrillo, DO, FACOEP, FACEP, Associate Professor, Emergency Medicine, Jefferson Medical College and Philadelphia College of Osteopathic Medicine; Medical Director, Department of Emergency Medicine, Einstein Elkins Park; Chair, Emergency Management Committee, Albert Einstein Healthcare Network; Medical Director, Disaster Medicine and Management Masters Program, Philadelphia University
Steven J Parrillo, DO, FACOEP, FACEP is a member of the following medical societies: American College of Emergency Physicians, American College of Osteopathic Emergency Physicians, American Osteopathic Association, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

Joseph A Salomone III, MD, EMS Medical Director, Kansas City, Missouri; Associate Professor and Staff Physician, Truman Medical Centers/UMKC School of Medicine
Joseph A Salomone III, MD is a member of the following medical societies: American Academy of Emergency Medicine, National Association of EMS Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

J Stephen Huff, MD, Associate Professor, Emergency Medicine and Neurology, Department of Emergency Medicine, University of Virginia Health Sciences Center
J Stephen Huff, MD is a member of the following medical societies: American Academy of Emergency Medicine, American Academy of Neurology, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Robert E O'Connor, MD, MPH, Professor and Chair, Department of Emergency Medicine, University of Virginia Health System
Robert E O'Connor, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Physician Executives, American Heart Association, American Medical Association, Medical Society of Delaware, National Association of EMS Physicians, Society for Academic Emergency Medicine, and Wilderness Medical Society
Disclosure: Nothing to disclose.

 
 
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