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Pain Medicine›Condition·Updated Jul 11, 2026·v1

Complex Regional Pain Syndrome

Complex Regional Pain Syndrome is a chronic pain condition with disproportionate pain, autonomic dysfunction, and trophic changes after injury. Diagnosis is clinical using Budapest criteria. Pathophysiology involves inflammation, autoimmunity, central sensitization, and cortical reorganization. First-line treatment includes antineuropathic agents and bisphosphonates; ketamine infusion and spinal cord stimulation are reserved for refractory cases. Early multidisciplinary rehabilitation and minimization of immobilization are key preventive strategies. Prognosis is guarded, with most patients experiencing persistent symptoms beyond 1 year.

Moderate Evidence289 references·10,822 words·44 min read·v1
Complex Regional Pain SyndromeCRPSreflex sympathetic dystrophychronic painneuropathic painnociplastic painBudapest criteriasympathetic blockspinal cord stimulation

Quick Reference

RxDrug of choiceGabapentin (300-3600 mg/day PO) or pregabalin (75-600 mg/day PO) for neuropathic pain component; bisphosphonates (alendronate 70 mg weekly or zoledronate 5 mg IV) for short-term pain reduction; ketamine IV infusion (0.1-0.35 mg/kg/h over 6 h × 5 days) for refractory pain.
AltAlternativesTopical diclofenac 1.5% gel for burning pain; amitriptyline 10-50 mg nightly for sleep and central sensitization; prednisolone 20-40 mg/day for acute inflammatory phase (<6 months); lidocaine IV 3 mg/kg weekly; transdermal fentanyl 12.5-50 μg/h (limited evidence, high side effects).
⊘AvoidNitrous oxide, intrathecal methylprednisolone, intrathecal glycine, IV regional guanethidine, Bier blocks with methylprednisolone/lidocaine, non-dihydropyridine CCBs (diltiazem, verapamil), all lack efficacy and may cause harm.
DxTest of choiceBudapest clinical diagnostic criteria (no single test confirms). Three-phase bone scintigraphy: sensitivity 40%, specificity 76.5%; positive test predicts favorable response to sympathetic blockade (OR 5.11). MRI reserved to exclude mimics.
ScKey scoreCRPS Severity Score (CSS), 17-item index (0-17) discriminating CRPS from other neuropathic pain, correlating with pain and disability; MCID ≥4.9 points.
→When to referAcute crisis with NRS ≥7 and autonomic instability → emergency sympathetic block. Chronic pain refractory to first-line pharmacotherapy → multidisciplinary pain clinic. Consideration for SCS/DRG-S → interventional pain specialist. Pediatric cases → pediatric pain clinic. Pregnancy with pre-existing SCS → coordinated peripartum planning.
CRPS is a chronic pain syndrome with mixed pathophysiology. Diagnose using Budapest criteria. Treat with multimodal ladder: antineuropathics → bisphosphonates → ketamine → SCS/DRG-S. Avoid ineffective interventions. Early rehabilitation and psychological support are essential. Prognosis is guarded, only 5% symptom-free at 1 year, but timely intervention improves function.
Complex Regional Pain Syndrome (CRPS) is a chronic pain condition characterized by disproportionate pain, autonomic dysfunction, and trophic changes, typically after trauma or surgery. It comprises two subtypes: CRPS-I (no nerve injury) and CRPS-II (identifiable nerve lesion). Diagnosis relies on the Budapest criteria, which offer high sensitivity (0.99) and improved specificity. Pathophysiology involves peripheral and central sensitization, neurogenic inflammation, autoantibodies, and cortical reorganization. Prognosis is guarded, only 5% are symptom-free at 1 year, but early multidisciplinary care, including graded motor imagery, bisphosphonates, and neuromodulation, can improve outcomes.

Overview and Recommendations

Background

  • •Complex Regional Pain Syndrome (CRPS) is a chronic pain disorder that arises disproportionately after a noxious event, historically termed reflex sympathetic dystrophy (RSD) or causalgia. Two subtypes exist: CRPS-I (90% of cases, no definable nerve lesion) and CRPS-II (identifiable peripheral nerve injury). The diagnosis is anchored by the Budapest criteria, which require continuing pain disproportionate to the inciting event plus at least one symptom in three of four categories (sensory, vasomotor, sudomotor/edema, motor/trophic) and at least one sign in two of those categories on examination, sensitivity 0.99, specificity 0.68-0.79.
  • •The condition reflects a mixed pain phenotype incorporating neuropathic, nociplastic, and nociceptive elements driven by four interacting axes: peripheral and central sensitization, neurogenic inflammation (substance P, CGRP, mast cell activation), autoantibody-mediated sensitization (against β2-adrenergic and M2 receptors), and cortical reorganization (shrinkage of somatosensory maps, putaminal gray matter loss). The clinical course evolves from a warm inflammatory phase to a cold chronic phase dominated by central maladaptive changes.
  • •CRPS imposes a substantial burden: incidence 26.2 per 100,000 person-years, female-to-male ratio 3.4:1, peak in women aged 61-70 years. Among fracture or surgery patients, pooled 12-month prevalence is 3.04%. Fracture is the most common antecedent (44%), with ankle fracture and intra-articular injury carrying particular risk. Persistent pain and motor dysfunction occur in 51-89% beyond 12 months, and 62% experience disability; only 5.4% are symptom-free at 1 year.
  • •Modifiable risk factors include prolonged immobilization >5 weeks (OR 26.9), vitamin D deficiency (OR 1.6-1.78), and high-energy triggering events. Female sex and preexisting PTSD (present in 38% of CRPS patients) are non-modifiable risk markers. Limited evidence suggests smoking may be protective (OR 0.41). The paradigm shift in management now emphasizes early multimodal rehabilitation, targeted pharmacotherapy, and neuromodulation over invasive sympathetic blocks.

Evaluation

  • •Suspect CRPS when a patient presents with pain that is strikingly disproportionate in severity and duration to the expected healing course after trauma, surgery, or immobilization. The pain is typically burning, aching, or shooting and accompanied by mechanical and thermal hyperalgesia, light touch (allodynia) or cold may be excruciating. Pain extends beyond a single dermatome or nerve territory, distinguishing CRPS from mononeuropathies.
  • •Ask about sensory symptoms (hyperalgesia to pinprick, allodynia to light touch, cold, deep pressure, or joint movement), vasomotor changes (temperature asymmetry, skin color changes, red, purple, pale, with dependency), sudomotor/edema (swelling, excessive sweating or dryness), and motor/trophic complaints (reduced range of motion, weakness, tremor, dystonia, nail/hair/skin changes). Also inquire about prior trauma, surgery, cast duration, and history of PTSD or anxiety.
  • •Examine for signs in four categories: sensory (pinprick hyperalgesia, dynamic and static mechanical allodynia), vasomotor (temperature asymmetry ≥1.0°C between affected and unaffected limb, skin color asymmetry), sudomotor/edema (visible edema, sweating asymmetry), and motor/trophic (reduced active range of motion, grip strength reduction 25-66%, nail ridging, increased or decreased hair growth, skin thinning). Temperature asymmetry should be measured at corresponding skin sites after 15 minutes of acclimation.
  • •Apply the Budapest diagnostic criteria systematically: continuing pain disproportionate to inciting event PLUS at least one symptom in three of the four categories PLUS at least one sign in two of the four categories. Meeting this clinical threshold has a sensitivity of 0.99 and specificity of 0.68; for research purposes, require symptoms in all four categories (specificity 0.79).
  • •Order plain radiographs of the affected limb to exclude occult fracture or regional osteopenia (present in 72% of early CRPS). Basic labs (CBC, ESR, CRP) help exclude infection or inflammatory arthritis. Reserve MRI for atypical presentations to rule out osteomyelitis, occult fracture, or soft-tissue infection, MRI has limited diagnostic accuracy for CRPS itself (sensitivity 6-91%, specificity 50-100%).
  • •Consider three-phase bone scintigraphy (TPBS) as a prognostic tool: sensitivity 40%, specificity 76.5% for CRPS by Budapest criteria, but a positive study (regional osteopenia) is associated with 6.30-fold higher odds of positive sympathetic blockade response (OR 5.11, 95% CI 1.49-17.53). TPBS should not be used to confirm or refute the diagnosis, the Budapest criteria remain the gold standard.
  • •Use the perfusion index derived from pulse oximetry as a more sensitive bedside vasomotor sign: a difference ≥0.50% between limbs has 78.3% sensitivity for detecting subjective thermal asymmetry (AUC 0.873), outperforming absolute temperature measurement (sensitivity only 34.8%).
  • •Quantify disease severity with the CRPS Severity Score (CSS), a 17-item continuous index (0-17) that discriminates CRPS from non-CRPS neuropathic pain (p<0.001) and correlates with pain intensity, distress, and functional impairment. A change of ≥4.9 points indicates real clinical change. The CSS is recommended as a core outcome measure in clinical studies.
  • •Also screen for common comorbidities: PTSD (38% of patients, usually predating CRPS onset), cognitive decline (objective decline in ~30%), and body perception disturbances (neglect-like symptoms, limb laterality recognition impairment). These factors affect treatment planning and perioperative risk.
  • •In pediatric patients, maintain a high index of suspicion in girls aged 12-15 years with unilateral lower limb pain (79.8% of cases), allodynia, and vasomotor changes. The Pediatric PainSCAN (sensitivity 76%, specificity 63%) can aid screening. Time from onset to diagnosis averages 5.6 months, earlier recognition improves outcomes.

Management

  • •Initiate a multimodal analgesia ladder starting with antineuropathic agents: gabapentin 300 mg PO daily, titrate to 3600 mg/day in three divided doses (adjust for CrCl <60 mL/min); or pregabalin 75 mg PO BID, titrate to 600 mg/day. Add topical 1.5% diclofenac gel for burning pain and allodynia (reduces VAS by 0.8 points, 95% CI 0.1-1.3).
  • •For sleep disruption and central sensitization, add low-dose amitriptyline 10-50 mg nightly (avoid in hepatic impairment; monitor QTc). For acute inflammatory CRPS (<6 months), consider a short course of oral prednisolone 20-40 mg daily for up to 4 weeks, a randomized trial showed improvement in CRPS scores, VAS, and sleep at 1 month with equal efficacy at both doses.
  • •If inadequate response to first-line agents, advance to bisphosphonates. 2025 meta-analysis of 11 RCTs (754 patients, 97% CRPS-I) shows short-term pain reduction (MD -10.0 on 0-100 scale at 4 weeks to 3 months, low certainty). Options: alendronate 70 mg PO weekly, intravenous neridronate 100 mg, or zoledronate 5 mg IV once. Check serum calcium and vitamin D before administration; avoid if CrCl <35 mL/min.
  • •For refractory pain (NRS ≥4 despite above), consider intravenous ketamine at subanesthetic doses. Meta-analysis of 7 RCTs (211 patients) shows reduction of 1.83 points on 0-10 NRS at ≤2 weeks (p<0.0001), NNT ≈3. A 5-day infusion regimen (0.1-0.35 mg/kg/h over 6 hours daily) provides best balance of efficacy and tolerability. Avoid 7-day regimen due to increased adverse events. Monitor cardiac output, dissociative symptoms, and hypertension.
  • •Intravenous lidocaine 3 mg/kg over 1 hour, administered weekly for 4 weeks, provides short-term analgesia in CRPS-II (p=0.011) but benefit is not sustained at 4-week follow-up. Reserve for patients who fail ketamine or have contraindications.
  • •Do NOT use nitrous oxide, a 2024 RCT found no difference from placebo (difference -0.57, 95% CI -1.42 to 0.28, p=0.19). Do NOT use intrathecal methylprednisolone 60 mg single bolus (no benefit, difference 0.3, 95% CI -0.7 to 1.3). Do NOT use intrathecal glycine (trend toward worsening). Do NOT use IV regional guanethidine (ineffective, high adverse events).
  • •For acute upper extremity CRPS crisis (NRS 7-10 with autonomic signs), perform ultrasound-guided thoracic paravertebral block (TPVB) at T2 with 10 mL 1% mepivacaine. Success rate (ΔT ≥1.5°C) is 62.9% vs 38.2% for stellate ganglion block; NRS at 20 minutes is 4.3 vs 5.4. For lower extremity crisis, perform lumbar sympathetic block with local anesthetic ± botulinum toxin 75 IU (prolongs pain reduction up to 3 months, P=0.003).
  • •For chronic CRPS (≥12 months) with persistent moderate-to-severe pain despite pharmacotherapy, refer for spinal cord stimulation (SCS) or dorsal root ganglion stimulation (DRG-S, now preferred per German guidelines). Systematic review: 67% of implanted patients achieve ≥50% pain relief over median 33 months. Brush-evoked allodynia predicts SCS failure (sensitivity 0.75, specificity 0.81).
  • •Reserve opioids for acute flares only. Transdermal fentanyl 12.5-50 μg/h has limited evidence, 1 in 3 patients withdrew during titration due to adverse events, and 90% experienced side effects. If opioids are needed, combine with NMDA-receptor antagonist (e.g., ketamine or dextromethorphan) to reduce tolerance and hyperalgesia; morphine 5-10 mg PO q4h PRN for breakthrough pain.
  • •Initiate early rehabilitation as soon as pain is controlled to prevent contractures and disuse. Graded motor imagery (hand laterality recognition, imagined movements, mirror therapy) has NNT of 2 for 50% pain reduction in chronic CRPS. Physical therapy focuses on range of motion, strength, and functional tasks; occupational therapy addresses ADLs and desensitization.
  • •Address psychological comorbidities: cognitive-behavioral therapy for pain-related fear and catastrophizing, graded exposure in vivo for disability. Pain catastrophizing does not contraindicate SCS. Screen for PTSD (38% prevalence) and provide trauma-informed care.
  • •For pediatric CRPS, prioritize early multidisciplinary care: NSAIDs (82.7% use), acetaminophen, physical therapy (83.3%), and multidisciplinary pain clinic referral (72.6%). Evidence for antiepileptic drugs and antidepressants in children is lacking. Continuous regional anesthesia plus inpatient rehabilitation achieves clinically significant benefit in 70%. SCS can be considered in highly selected refractory adolescents; device removal may be possible after recovery.
  • •For pregnant women with pre-existing SCS, the device is safe; neuraxial anesthesia for delivery remains feasible. Coordinate multidisciplinary planning with pain specialist, obstetrician, and anesthesiologist. Drug selection must balance maternal pain relief against fetal risk, gabapentin and amitriptyline are relatively safe, but NSAIDs should be avoided after 32 weeks gestation.
  • •Prevent CRPS by minimizing immobilization to <5 weeks after fracture. Cross-education training (isokinetic strengthening of uninjured limb during cast) reduces CRPS incidence after distal radius fracture. Vitamin C prophylaxis remains debated (meta-analysis shows positive direction but not statistically significant). Vaccination is safe, no causal link between HPV or COVID-19 vaccines and CRPS.
  • •Discharge criteria for acute exacerbation: pain NRS ≤3 on oral multimodal analgesia, autonomic signs improved, patient able to participate in physical therapy, clear escalation plan in place. Arrange outpatient follow-up within 1-2 weeks for consideration of repeat blocks or neuromodulation.

Board Review — High Yield

  • •Budapest criteria, Gold standard for diagnosis: continuing pain disproportionate to inciting event + ≥1 symptom in 3 of 4 categories + ≥1 sign in 2 of 4 categories. Sensitivity 0.99, specificity 0.68 (clinical) / 0.79 (research).
  • •CRPS subtypes, Type I (90%, no nerve lesion, formerly RSD) vs Type II (identifiable nerve injury, formerly causalgia).
  • •Warm-to-cold transition, Acute phase dominated by neurogenic inflammation (warm, red, edematous); chronic phase by central reorganization and vasoconstriction (cold, cyanotic, trophic changes). Therapeutic windows differ.
  • •Bisphosphonate efficacy, 2025 meta-analysis: short-term pain reduction (MD -10.0 on 0-100 scale, low certainty); benefit uncertain beyond 3 months. NNT not calculable.
  • •Ketamine NNT ≈ 3, 5-day infusion (0.1-0.35 mg/kg/h) provides best balance; responder rate 51.3% vs 19.4% (RR 2.43). Avoid 7-day regimen.
  • •SCS success rate 67%, ≥50% pain relief over median 33 months. Brush-evoked allodynia is negative predictor (sensitivity 0.75, specificity 0.81). DRG-S now preferred.
  • •Sympathetic block technique, Upper extremity: T2 paravertebral block (62.9% success) superior to stellate ganglion block (38.2%). Lower extremity: lumbar sympathetic block; botulinum toxin 75 IU prolongs effect.
  • •Immobilization >5 weeks, Strongest modifiable risk factor (OR 26.9) after distal radius fracture; minimize cast duration.
  • •Pediatric CRPS, Most common in girls 12-15 years, lower limb 80%. Early multidisciplinary care is cornerstone; SCS can be used in selected refractory cases.
  • •No vaccine causality, Population-based studies show no association between HPV vaccination and CRPS (rate ratio 1.31, 95% CI 0.91-1.90); vaccination should not be withheld.

Deep Dive — Evidence Details

References

  1. [1]

    Hussain N, Brull R, Shah R et al.. “Evaluating the Statistical Robustness of Randomized Controlled Trials of Spinal Cord Stimulation for Pain through the Use of Fragility Index.” Anesthesiology (2025). PMID: 41376548 ↗

    L5SR_MA_RCTCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Diagnosis and Workup, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Regional and Interventional Procedures, Complications, Prognosis and Natural History
  2. [2]

    Dworkin RH, O'Connor AB, Kent J et al.. “Interventional management of neuropathic pain: NeuPSIG recommendations.” Pain (2013). PMID: 23748119 ↗

    L1GUIDELINECited in: Definition, Classification and Pain Phenotype, Pathophysiology and Mechanism, Clinical Presentation, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Complications
  3. [3]

    Mekhail N, Visnjevac O, Azer G et al.. “Spinal Cord Stimulation 50 Years Later: Clinical Outcomes of Spinal Cord Stimulation Based on Randomized Clinical Trials-A Systematic Review.” Regional anesthesia and pain medicine (2018). PMID: 29481371 ↗

    L1SR_OBSCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Diagnosis and Workup, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Regional and Interventional Procedures, Prognosis and Natural History
  4. [4]

    Terkelsen AJ, Gierthmühlen J, Finnerup NB et al.. “Bilateral hypersensitivity to capsaicin, thermal, and mechanical stimuli in unilateral complex regional pain syndrome.” Anesthesiology (2014). PMID: 24621686 ↗

    L3RCTCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Diagnosis and Workup, History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Special Populations and Pregnancy
  5. [5]

    Ahmed SU, Zhang Y, Chen L et al.. “Effect of 1.5% Topical Diclofenac on Clinical Neuropathic Pain.” Anesthesiology (2015). PMID: 25955980 ↗

    L1RCTCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Diagnosis and Workup, History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Complications, Prognosis and Natural History, Special Populations and Pregnancy
  6. [6]

    Kim YC, Castañeda AM, Lee CS et al.. “Efficacy and Safety of Lidocaine Infusion Treatment for Neuropathic Pain: A Randomized, Double-Blind, and Placebo-Controlled Study.” Regional anesthesia and pain medicine (2018). PMID: 29381569 ↗

    L1RCTCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Diagnosis and Workup, History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Complications, Prognosis and Natural History, Special Populations and Pregnancy
  7. [7]

    Hale J, Xu J, Wang D et al.. “Nitrous oxide for the treatment of complex regional pain syndrome: a randomized blinded trial.” Regional anesthesia and pain medicine (2024). PMID: 37898481 ↗

    L1RCTCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Diagnosis and Workup, History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Prognosis and Natural History, Special Populations and Pregnancy
  8. [8]

    Orhurhu V, Orhurhu MS, Bhatia A et al.. “Ketamine Infusions for Chronic Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials.” Anesthesia and analgesia (2019). PMID: 31082965 ↗

    L1SR_MA_RCTCited in: Definition, Classification and Pain Phenotype, Pathophysiology and Mechanism, Clinical Presentation, Diagnosis and Workup, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Complications, Prognosis and Natural History
  9. [9]

    Ranathunga N, Sterling M, Sierra-Silvestre E et al.. “Small nerve fibre pathology in non-neuropathic chronic pain conditions: a systematic review and meta-analysis.” Pain (2025). PMID: 41114676 ↗

    L1SR_OBSCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Complications
  10. [10]

    Park R, Ho AM, Pickering G et al.. “Efficacy and Safety of Magnesium for the Management of Chronic Pain in Adults: A Systematic Review.” Anesthesia and analgesia (2020). PMID: 32049671 ↗

    L1SR_OBSCited in: Definition, Classification and Pain Phenotype, Epidemiology, Etiology and Risk Factors, Clinical Presentation, Diagnosis and Workup, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Complications, Prognosis and Natural History
  11. [11]

    Kim J, Cha J, Choi SN et al.. “Multicenter Prospective Randomized Comparison of Ultrasound-Guided Stellate Ganglion Versus Thoracic Paravertebral Block for Sympathetic Blockade in Chronic Upper Extremity Pain.” Anesthesia and analgesia (2024). PMID: 39976623 ↗

    L1RCTCited in: Definition, Classification and Pain Phenotype, Pathophysiology and Mechanism, Clinical Presentation, Diagnosis and Workup, Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care, Acute Management and Crisis Pathways, History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Regional and Interventional Procedures, Complications, Prognosis and Natural History, Special Populations and Pregnancy
  12. [12]

    van der Plas AA, van Rijn MA, Marinus J et al.. “Efficacy of intrathecal baclofen on different pain qualities in complex regional pain syndrome.” Anesthesia and analgesia (2012). PMID: 23223108 ↗

    L4RCTCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Diagnosis and Workup, Severity, Staging and Perioperative Risk Stratification, History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Regional and Interventional Procedures
  13. [13]

    Brunner F, Schmid A, Kissling R et al.. “Biphosphonates for the therapy of complex regional pain syndrome I--systematic review.” European journal of pain (London, England) (2008). PMID: 18440845 ↗

    L1SR_OBSCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Diagnosis and Workup
  14. [14]

    Johnson S, Cowell F, Gillespie S et al.. “Complex regional pain syndrome what is the outcome? - a systematic review of the course and impact of CRPS at 12 months from symptom onset and beyond.” European journal of pain (London, England) (2022). PMID: 35435302 ↗

    L2SR_OBSCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Diagnosis and Workup
  15. [15]

    Minerbi A, Shen S. “Gut Microbiome in Anesthesiology and Pain Medicine.” Anesthesiology (2022). PMID: 35486831 ↗

    L5REVIEW_NARRATIVECited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Complications
  16. [16]

    Bruehl S. “An update on the pathophysiology of complex regional pain syndrome.” Anesthesiology (2010). PMID: 20693883 ↗

    L5REVIEW_NARRATIVECited in: Definition, Classification and Pain Phenotype, Pathophysiology and Mechanism
  17. [17]

    Stanton-Hicks MD. “CRPS: what's in a name? Taxonomy, epidemiology, neurologic, immune and autoimmune considerations.” Regional anesthesia and pain medicine (2019). PMID: 30777902 ↗

    L5REVIEW_NARRATIVECited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Severity, Staging and Perioperative Risk Stratification, History and Evolution of Treatment
  18. [18]

    Liesto S, Aho T, Jääskeläinen SK et al.. “Cognitive Function in Patients With Complex Regional Pain Syndrome (CRPS).” European journal of pain (London, England) (2025). PMID: 40626344 ↗

    L4RCTCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Diagnosis and Workup, Severity, Staging and Perioperative Risk Stratification, History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Special Populations and Pregnancy
  19. [19]

    Zhang H, Li F, Li WW et al.. “The inflammasome as a target for pain therapy.” British journal of anaesthesia (2016). PMID: 27956668 ↗

    L5REVIEW_NARRATIVECited in: Definition, Classification and Pain Phenotype, Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  20. [20]

    Birklein F, Schlereth T. “Complex regional pain syndrome-significant progress in understanding.” Pain (2015). PMID: 25789441 ↗

    L5REVIEW_NARRATIVECited in: Definition, Classification and Pain Phenotype, Pathophysiology and Mechanism, Prognosis and Natural History
  21. [21]

    Sommer C, Leinders M, Üçeyler N. “Inflammation in the pathophysiology of neuropathic pain.” Pain (2018). PMID: 29447138 ↗

    L5REVIEW_NARRATIVECited in: Definition, Classification and Pain Phenotype, Pathophysiology and Mechanism, Clinical Presentation
  22. [22]

    Russo MA, Baron R, Dickenson AH et al.. “Ambroxol for neuropathic pain: hiding in plain sight?” Pain (2022). PMID: 35580314 ↗

    L5REVIEW_NARRATIVECited in: Definition, Classification and Pain Phenotype, Pathophysiology and Mechanism, Clinical Presentation, Diagnosis and Workup, History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Complications
  23. [23]

    Dahan A, Olofsen E, Niesters M. “Pharmacotherapy for pain: efficacy and safety issues examined by subgroup analyses.” Pain (2015). PMID: 25789429 ↗

    L5REVIEW_NARRATIVECited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Diagnosis and Workup, Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  24. [24]

    Gharibo C, Day M, Aydin SM et al.. “Diagnostic Guidance for Chronic Complex Regional Pain Syndrome Type I and Type II from The American Society of Interventional Physicians (ASIPP).” Pain physician (2025). PMID: 40773629 ↗

    L1GUIDELINECited in: Definition, Classification and Pain Phenotype, Pathophysiology and Mechanism, Clinical Presentation, Diagnosis and Workup, History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Regional and Interventional Procedures, Prognosis and Natural History
  25. [25]

    Smart KM, Ferraro MC, Wand BM et al.. “Physiotherapy for pain and disability in adults with complex regional pain syndrome (CRPS) types I and II.” The Cochrane database of systematic reviews (2022). PMID: 35579382 ↗

    L1SR_OBSCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Diagnosis and Workup, Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  26. [26]

    Smart KM, Wand BM, O'Connell NE. “Physiotherapy for pain and disability in adults with complex regional pain syndrome (CRPS) types I and II.” The Cochrane database of systematic reviews (2016). PMID: 26905470 ↗

    L1SR_OBSCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Diagnosis and Workup, Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  27. [27]

    Straube S, Derry S, Moore RA et al.. “Cervico-thoracic or lumbar sympathectomy for neuropathic pain and complex regional pain syndrome.” The Cochrane database of systematic reviews (2013). PMID: 23999944 ↗

    L1SR_OBSCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Regional and Interventional Procedures
  28. [28]

    Derry S, Stannard C, Cole P et al.. “Fentanyl for neuropathic pain in adults.” The Cochrane database of systematic reviews (2016). PMID: 27727431 ↗

    L1SR_OBSCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Diagnosis and Workup, Acute Management and Crisis Pathways, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Special Populations and Pregnancy
  29. [29]

    Straube S, Derry S, Moore RA et al.. “Cervico-thoracic or lumbar sympathectomy for neuropathic pain and complex regional pain syndrome.” The Cochrane database of systematic reviews (2010). PMID: 20614432 ↗

    L1SR_OBSCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Regional and Interventional Procedures
  30. [30]

    Cooper TE, Heathcote LC, Clinch J et al.. “Antidepressants for chronic non-cancer pain in children and adolescents.” The Cochrane database of systematic reviews (2017). PMID: 28779487 ↗

    L1SR_OBSCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Acute Management and Crisis Pathways, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Complications, Special Populations and Pregnancy
  31. [31]

    Cooper TE, Wiffen PJ, Heathcote LC et al.. “Antiepileptic drugs for chronic non-cancer pain in children and adolescents.” The Cochrane database of systematic reviews (2017). PMID: 28779491 ↗

    L1SR_OBSCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Acute Management and Crisis Pathways, Complications, Special Populations and Pregnancy
  32. [32]

    Agarwal-Kozlowski K, Lorke DE, Habermann CR et al.. “Interventional management of intractable sympathetically mediated pain by computed tomography-guided catheter implantation for block and neuroablation of the thoracic sympathetic chain: technical approach and review of 322 procedures.” Anaesthesia (2011). PMID: 21564048 ↗

    L4REVIEW_NARRATIVECited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Diagnosis and Workup, Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care, Regional and Interventional Procedures, Special Populations and Pregnancy
  33. [33]

    Sawynok J. “Topical and peripheral ketamine as an analgesic.” Anesthesia and analgesia (2014). PMID: 24945127 ↗

    L5REVIEW_NARRATIVECited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Complications
  34. [34]

    Rijsdijk M, van Wijck AJ, Kalkman CJ et al.. “The effects of glucocorticoids on neuropathic pain: a review with emphasis on intrathecal methylprednisolone acetate delivery.” Anesthesia and analgesia (2014). PMID: 24781577 ↗

    L5REVIEW_NARRATIVECited in: Definition, Classification and Pain Phenotype, Clinical Presentation, History and Evolution of Treatment, Regional and Interventional Procedures
  35. [35]

    Goudman L, Moens M, Pilitsis JG. “Incidence and Prevalence of Pain Medication Prescriptions in Pathologies with a Potential for Chronic Pain.” Anesthesiology (2024). PMID: 38081041 ↗

    L2OTHERCited in: Definition, Classification and Pain Phenotype, Epidemiology, Etiology and Risk Factors, Clinical Presentation, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Complications
  36. [36]

    Terkelsen AJ, Mølgaard H, Hansen J et al.. “Heart rate variability in complex regional pain syndrome during rest and mental and orthostatic stress.” Anesthesiology (2012). PMID: 22089824 ↗

    L3OTHERCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Diagnosis and Workup
  37. [37]

    van Eijs F, Geurts J, van Kleef M et al.. “Predictors of pain relieving response to sympathetic blockade in complex regional pain syndrome type 1.” Anesthesiology (2012). PMID: 22143169 ↗

    L4OTHERCited in: Definition, Classification and Pain Phenotype, Epidemiology, Etiology and Risk Factors, Clinical Presentation, Diagnosis and Workup, Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Regional and Interventional Procedures, Complications, Prognosis and Natural History
  38. [38]

    Tajerian M, Leu D, Yang P et al.. “Differential Efficacy of Ketamine in the Acute versus Chronic Stages of Complex Regional Pain Syndrome in Mice.” Anesthesiology (2015). PMID: 26492479 ↗

    L5OTHERCited in: Definition, Classification and Pain Phenotype, Diagnosis and Workup, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Prognosis and Natural History
  39. [39]

    Donado C, Lobo K, Velarde-Álvarez MF et al.. “Continuous Regional Anesthesia and Inpatient Rehabilitation for Pediatric Complex Regional Pain Syndrome.” Regional anesthesia and pain medicine (2017). PMID: 28492436 ↗

    L4OTHERCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Diagnosis and Workup, Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care, Regional and Interventional Procedures, Complications, Special Populations and Pregnancy
  40. [40]

    Kim J, Yun M, Han AH et al.. “Thoracic sympathetic ganglion blocks: real-world outcomes in 207 chronic pain patients.” Regional anesthesia and pain medicine (2024). PMID: 37726196 ↗

    L4OTHERCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Diagnosis and Workup, Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care, Regional and Interventional Procedures, Complications, Prognosis and Natural History, Special Populations and Pregnancy
  41. [41]

    Alam OH, Zaidi B, Pierce J et al.. “Phenotypic features of patients with complex regional pain syndrome compared with those with neuropathic pain.” Regional anesthesia and pain medicine (2019). PMID: 31278203 ↗

    L3OTHERCited in: Definition, Classification and Pain Phenotype, Severity, Staging and Perioperative Risk Stratification
  42. [42]

    Sharma A, Agarwal S, Broatch J et al.. “A web-based cross-sectional epidemiological survey of complex regional pain syndrome.” Regional anesthesia and pain medicine (2009). PMID: 19282709 ↗

    L4OTHERCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Diagnosis and Workup, Prognosis and Natural History, Special Populations and Pregnancy
  43. [43]

    Kroin JS, Das V, Moric M et al.. “Efficacy of the ketamine metabolite (2R,6R)-hydroxynorketamine in mice models of pain.” Regional anesthesia and pain medicine (2019). PMID: 30640662 ↗

    L5OTHERCited in: Definition, Classification and Pain Phenotype, Diagnosis and Workup, Prognosis and Natural History
  44. [44]

    Teckchandani S, Nagana Gowda GA, Raftery D et al.. “Metabolomics in chronic pain research.” European journal of pain (London, England) (2020). PMID: 33065770 ↗

    L5REVIEW_NARRATIVECited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Complications
  45. [45]

    Møller Johansen L, Gerra MC, Arendt-Nielsen L. “Time course of DNA methylation in pain conditions: From experimental models to humans.” European journal of pain (London, England) (2020). PMID: 33063322 ↗

    L5REVIEW_NARRATIVECited in: Definition, Classification and Pain Phenotype, Complications
  46. [46]

    Verspyck E, Attal N. “Diagnosing nociplastic pain in cancer survivors: a major step forward.” British journal of anaesthesia (2023). PMID: 36890060 ↗

    L5OTHERCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Complications
  47. [47]

    Friesgaard KD, Gromov K, Knudsen LF et al.. “Persistent pain is common 1 year after ankle and wrist fracture surgery: a register-based questionnaire study.” British journal of anaesthesia (2016). PMID: 27106969 ↗

    L2OTHERCited in: Definition, Classification and Pain Phenotype, Epidemiology, Etiology and Risk Factors, Clinical Presentation, Diagnosis and Workup, Complications, Special Populations and Pregnancy, Prevention, Screening and Surveillance
  48. [48]

    Harden NR, Bruehl S, Perez RSGM et al.. “Validation of proposed diagnostic criteria (the "Budapest Criteria") for Complex Regional Pain Syndrome.” Pain (2010). PMID: 20493633 ↗

    L3OTHERCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Diagnosis and Workup
  49. [49]

    Drummond PD, Rossen-Abercromby M, Quartermaine A et al.. “Spatial distribution of pain in complex regional pain syndrome.” Pain (2025). PMID: 40372287 ↗

    L4OTHERCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Diagnosis and Workup, Special Populations and Pregnancy
  50. [50]

    Baerg K, Tupper SM, Chu LM et al.. “Canadian surveillance study of complex regional pain syndrome in children.” Pain (2021). PMID: 34799536 ↗

    L2OTHERCited in: Definition, Classification and Pain Phenotype, Epidemiology, Etiology and Risk Factors, Clinical Presentation, Diagnosis and Workup, Special Populations and Pregnancy, Prevention, Screening and Surveillance
  51. [51]

    Wong VCY, De Vos MD, Osborn J et al.. “Risk Factors for Spinal Cord Stimulator Explant After Implantation for Neuropathic Pain: A Systematic Review.” Neuromodulation : journal of the International Neuromodulation Society (2026). PMID: 41793406 ↗

    L2SR_OBSCited in: Definition, Classification and Pain Phenotype, Regional and Interventional Procedures
  52. [52]

    Quodling N, Hoffman N, Carrick FR et al.. “Beyond the Pain: Rethinking Chronic Pain Management Through Integrated Therapeutic Approaches-A Systematic Review.” International journal of molecular sciences (2026). PMID: 41683658 ↗

    L5SR_OBSCited in: Definition, Classification and Pain Phenotype, Pathophysiology and Mechanism, Clinical Presentation, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Complications
  53. [53]

    Slotty PJ, Rasche D, Vesper J. “[German guideline on spinal cord stimulation for chronic neuropathic pain].” Schmerz (Berlin, Germany) (2026). PMID: 42126579 ↗

    L1GUIDELINECited in: Definition, Classification and Pain Phenotype, History and Evolution of Treatment, Regional and Interventional Procedures
  54. [54]

    Lafuma P, Magaud L, Abichou-Klich A et al.. “Mesotherapy With Lidocaine and Ketamine in Complex Regional Pain Syndrome Type 1: A Randomized Double-Blind Trial.” Pain practice : the official journal of World Institute of Pain (2026). PMID: 42421175 ↗

    L1RCTCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Diagnosis and Workup, History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Prognosis and Natural History
  55. [55]

    Abo Elsafa AM, El Tatawy HI, Alzeftawy AE et al.. “Assessment of Three Regimens of Ketamine Infusion in Complex Regional Pain Syndrome: A Randomized Prospective Comparative Study.” Pain physician (2025). PMID: 41337772 ↗

    L1RCTCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Diagnosis and Workup, Severity, Staging and Perioperative Risk Stratification, History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Prognosis and Natural History
  56. [56]

    Akıncı MG, Polat CS, Tombak Demirçakan A et al.. “Effectiveness of contrast compression therapy for post-stroke complex regional pain syndrome: a randomized control trial.” Topics in stroke rehabilitation (2025). PMID: 41261073 ↗

    L1RCTCited in: Definition, Classification and Pain Phenotype, Clinical Presentation, Diagnosis and Workup, History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Special Populations and Pregnancy
  57. [57]

    Das V, Kroin JS, Moric M et al.. “Early Treatment With Metformin in a Mice Model of Complex Regional Pain Syndrome Reduces Pain and Edema.” Anesthesia and analgesia (2020). PMID: 30801357 ↗

    L5OTHERCited in: Definition, Classification and Pain Phenotype, Clinical Presentation
  58. [58]

    Guo TZ, Shi X, Li W et al.. “Dimethyl Fumarate Reduces Oxidative Stress and Pronociceptive Immune Responses in a Murine Model of Complex Regional Pain Syndrome.” Anesthesia and analgesia (2021). PMID: 33646995 ↗

    L5OTHERCited in: Definition, Classification and Pain Phenotype, Pathophysiology and Mechanism, Clinical Presentation, Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  59. [59]

    Laferrière A, Abaji R, Tsai CY et al.. “Topical combinations to treat microvascular dysfunction of chronic postischemia pain.” Anesthesia and analgesia (2014). PMID: 24651238 ↗

    L5OTHERCited in: Definition, Classification and Pain Phenotype, Pathophysiology and Mechanism, Clinical Presentation, Diagnosis and Workup, Complications
  60. [60]

    van Velzen GAJ, Huygen FJPM, van Kleef M et al.. “Sex matters in complex regional pain syndrome.” European journal of pain (London, England) (2019). PMID: 30735277 ↗

    L4OTHERCited in: Definition, Classification and Pain Phenotype, Epidemiology, Etiology and Risk Factors, Diagnosis and Workup, Severity, Staging and Perioperative Risk Stratification
  61. [61]

    Scheuren PS, De Schoenmacker I, Rosner J et al.. “Pain-autonomic measures reveal nociceptive sensitization in complex regional pain syndrome.” European journal of pain (London, England) (2022). PMID: 36130736 ↗

    L3OTHERCited in: Definition, Classification and Pain Phenotype, Diagnosis and Workup, Complications
  62. [62]

    Voute M, Riant T, Amodéo JM et al.. “Ketamine in chronic pain: A Delphi survey.” European journal of pain (London, England) (2022). PMID: 35092320 ↗

    L5OTHERCited in: Definition, Classification and Pain Phenotype, Complications
  63. [63]

    van den Berg C, van den Berg E, Huygen FJPM et al.. “Cognitive Function in Patients With Complex Regional Pain Syndrome: No Clear Impairment Found in a Select Patient Sample.” European journal of pain (London, England) (2025). PMID: 40454604 ↗

    L3OTHERCited in: Definition, Classification and Pain Phenotype, Diagnosis and Workup, Special Populations and Pregnancy
  64. [64]

    Mesaroli G, Hundert A, Birnie KA et al.. “Screening and diagnostic tools for complex regional pain syndrome: a systematic review.” Pain (2021). PMID: 33230004 ↗

    L2SR_OBSCited in: Pathophysiology and Mechanism, Special Populations and Pregnancy
  65. [65]

    Beerthuizen A, van 't Spijker A, Huygen FJ et al.. “Is there an association between psychological factors and the Complex Regional Pain Syndrome type 1 (CRPS1) in adults? A systematic review.” Pain (2009). PMID: 19573987 ↗

    L2SR_OBSCited in: Pathophysiology and Mechanism
  66. [66]

    Olofsen E, Sigtermans M, Noppers I et al.. “The dose-dependent effect of S(+)-ketamine on cardiac output in healthy volunteers and complex regional pain syndrome type 1 chronic pain patients.” Anesthesia and analgesia (2012). PMID: 22575567 ↗

    L4RCTCited in: Pathophysiology and Mechanism, Diagnosis and Workup, History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Complications
  67. [67]

    Mountford R, Mattocks G, Rittner HL et al.. “Clinical Presentation of Shoulder-Hand Syndrome: A Systematic Review.” European journal of pain (London, England) (2026). PMID: 41637667 ↗

    L4SR_OBSCited in: Pathophysiology and Mechanism, Clinical Presentation, Diagnosis and Workup
  68. [68]

    van den Berg C, de Bree PN, Huygen FJPM et al.. “Glucocorticoid treatment in patients with complex regional pain syndrome: A systematic review.” European journal of pain (London, England) (2022). PMID: 35983980 ↗

    L2SR_OBSCited in: Pathophysiology and Mechanism, Clinical Presentation
  69. [69]

    Wittkopf PG, Lloyd DM, Johnson MI. “The effect of visual feedback of body parts on pain perception: A systematic review of clinical and experimental studies.” European journal of pain (London, England) (2017). PMID: 29271535 ↗

    L1SR_OBSCited in: Pathophysiology and Mechanism
  70. [70]

    van Eijs F, Smits H, Geurts JW et al.. “Brush-evoked allodynia predicts outcome of spinal cord stimulation in complex regional pain syndrome type 1.” European journal of pain (London, England) (2009). PMID: 19942463 ↗

    L2RCTCited in: Pathophysiology and Mechanism, History and Evolution of Treatment, Regional and Interventional Procedures, Complications, Prognosis and Natural History, Special Populations and Pregnancy
  71. [71]

    Shim H, Rose J, Halle S et al.. “Complex regional pain syndrome: a narrative review for the practising clinician.” British journal of anaesthesia (2019). PMID: 31056241 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology and Mechanism
  72. [72]

    Üçeyler N. “Small fiber pathology--a culprit for many painful disorders?” Pain (2016). PMID: 26780379 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology and Mechanism, Clinical Presentation
  73. [73]

    Gonzalez E, Sahar T, Haddad M et al.. “Altered Gut Microbiome Composition and Function in Individuals with Complex Regional Pain Syndrome.” Anesthesiology (2025). PMID: 40042519 ↗

    L3OTHERCited in: Pathophysiology and Mechanism, Special Populations and Pregnancy
  74. [74]

    Li WW, Guo TZ, Liang DY et al.. “Substance P signaling controls mast cell activation, degranulation, and nociceptive sensitization in a rat fracture model of complex regional pain syndrome.” Anesthesiology (2012). PMID: 22343473 ↗

    L5OTHERCited in: Pathophysiology and Mechanism, Clinical Presentation, Diagnosis and Workup
  75. [75]

    Zhu H, Wen B, Xu J et al.. “Wnt5a in keratinocytes contributes to complex regional pain syndrome through the activation of NR2B and MMP9 in rats.” Regional anesthesia and pain medicine (2026). PMID: 40081928 ↗

    L5OTHERCited in: Pathophysiology and Mechanism
  76. [76]

    Swart CM, Stins JF, Beek PJ. “Cortical changes in complex regional pain syndrome (CRPS).” European journal of pain (London, England) (2008). PMID: 19101181 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology and Mechanism
  77. [77]

    Torta DM, Legrain V, Rossetti Y et al.. “Prisms for pain. Can visuo-motor rehabilitation strategies alleviate chronic pain?” European journal of pain (London, England) (2015). PMID: 26095341 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology and Mechanism, Clinical Presentation, Complications
  78. [78]

    Cuhadar U, Gentry C, Vastani N et al.. “Autoantibodies produce pain in complex regional pain syndrome by sensitizing nociceptors.” Pain (2019). PMID: 31343542 ↗

    L5OTHERCited in: Pathophysiology and Mechanism, Diagnosis and Workup, Complications
  79. [79]

    Drummond PD, Finch PM, Birklein F et al.. “Hemisensory disturbances in patients with complex regional pain syndrome.” Pain (2018). PMID: 29787471 ↗

    L4OTHERCited in: Pathophysiology and Mechanism, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Special Populations and Pregnancy
  80. [80]

    Dharmalingam B, Singh P, Schramm P et al.. “Autoantibodies from patients with complex regional pain syndrome induce pro-inflammatory effects and functional disturbances on endothelial cells in vitro.” Pain (2022). PMID: 35384930 ↗

    L5OTHERCited in: Pathophysiology and Mechanism
  81. [81]

    König S, Bayer M, Dimova V et al.. “The serum protease network-one key to understand complex regional pain syndrome pathophysiology.” Pain (2019). PMID: 30694931 ↗

    L3OTHERCited in: Pathophysiology and Mechanism, Diagnosis and Workup
  82. [82]

    Azqueta-Gavaldon M, Youssef AM, Storz C et al.. “Implications of the putamen in pain and motor deficits in complex regional pain syndrome.” Pain (2020). PMID: 31693538 ↗

    L4OTHERCited in: Pathophysiology and Mechanism, Diagnosis and Workup, Complications
  83. [83]

    Leys AM, Hans GH, Saldien V et al.. “Hyperbaric Oxygen Therapy in Managing Chronic Pain Syndromes - A Systematic Review.” Journal of pain research (2026). PMID: 41913797 ↗

    L1SR_OBSCited in: Pathophysiology and Mechanism
  84. [84]

    Brun C, Mercier C, Grieve S et al.. “Sensory disturbances induced by sensorimotor conflicts are higher in complex regional pain syndrome and fibromyalgia compared to arthritis and healthy people, and positively relate to pain intensity.” European journal of pain (London, England) (2018). PMID: 30288850 ↗

    L4OTHERCited in: Pathophysiology and Mechanism
  85. [85]

    Breimhorst M, Dellen C, Wittayer M et al.. “Mental load during cognitive performance in complex regional pain syndrome I.” European journal of pain (London, England) (2018). PMID: 29635839 ↗

    L3OTHERCited in: Pathophysiology and Mechanism, Special Populations and Pregnancy
  86. [86]

    Kindl G, Teichmüller K, Escolano-Lozano F et al.. “Pain, disability, and lifestyle: Patients with complex regional pain syndrome compared to chronic musculoskeletal pain-A retrospective analysis.” European journal of pain (London, England) (2022). PMID: 34958709 ↗

    L3OTHERCited in: Pathophysiology and Mechanism, Epidemiology, Etiology and Risk Factors, Severity, Staging and Perioperative Risk Stratification, Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  87. [87]

    Guhl C, Birklein F, Hirsch S. “Sweating disorders in mice with and without nerve lesions.” European journal of pain (London, England) (2019). PMID: 30582875 ↗

    L5OTHERCited in: Pathophysiology and Mechanism
  88. [88]

    Kumowski N, Hegelmaier T, Kolbenschlag J et al.. “Unimpaired endogenous pain inhibition in the early phase of complex regional pain syndrome.” European journal of pain (London, England) (2017). PMID: 28146319 ↗

    L3OTHERCited in: Pathophysiology and Mechanism
  89. [89]

    Ragavendran JV, Laferrière A, Khorashadi M et al.. “Pentoxifylline reduces chronic post-ischaemia pain by alleviating microvascular dysfunction.” European journal of pain (London, England) (2013). PMID: 23904273 ↗

    L5OTHERCited in: Pathophysiology and Mechanism
  90. [90]

    Noble RK, Duplechin MO, Anwar AI et al.. “Erythromelalgia: Pathophysiology and Clinical Treatment Options, a Narrative Review.” Current pain and headache reports (2026). PMID: 42207226 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology and Mechanism
  91. [91]

    Doan HN, Chang MC. “Comprehensive Mechanisms and Non-Invasive Treatment for Complex Regional Pain Syndrome: A Narrative Review.” Journal of pain research (2025). PMID: 40959210 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology and Mechanism
  92. [92]

    Lopes R, Santos A, Gomes T et al.. “An Integrative Review of Potential Diagnostic Biomarkers for Complex Regional Pain Syndrome.” Journal of clinical medicine (2025). PMID: 40507512 ↗

    L3REVIEW_NARRATIVECited in: Pathophysiology and Mechanism
  93. [93]

    Malik A, Javed S. “Does Chemotherapy-Induced Peripheral Neuropathy Fall Within the Spectrum of Complex Regional Pain Syndrome? A Narrative Review.” Current pain and headache reports (2025). PMID: 40257707 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology and Mechanism
  94. [94]

    Pirri C, Pirri N, Petrelli L et al.. “An Emerging Perspective on the Role of Fascia in Complex Regional Pain Syndrome: A Narrative Review.” International journal of molecular sciences (2025). PMID: 40141468 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology and Mechanism
  95. [95]

    Varenna M, Zucchi F, Di Taranto R et al.. “Osteoclast in CRPS: an alleged guilty fully acquitted.” Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA (2025). PMID: 39915338 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology and Mechanism
  96. [96]

    Jevotovsky DS, Oehlermarx W, Chen T et al.. “Weathering the Pain: Ambient Temperature's Role in Chronic Pain Syndromes.” Current pain and headache reports (2025). PMID: 39847186 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology and Mechanism
  97. [97]

    Suter M, Bollen Pinto B, Belletti A et al.. “Efficacy and safety of perioperative vitamin C in patients undergoing noncardiac surgery: a systematic review and meta-analysis of randomised trials.” British journal of anaesthesia (2022). PMID: 35090721 ↗

    L1SR_OBSCited in: Epidemiology, Etiology and Risk Factors, Clinical Presentation, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Complications
  98. [98]

    Beerthuizen A, Stronks DL, Van't Spijker A et al.. “Demographic and medical parameters in the development of complex regional pain syndrome type 1 (CRPS1): prospective study on 596 patients with a fracture.” Pain (2012). PMID: 22386473 ↗

    L2COHORTCited in: Epidemiology, Etiology and Risk Factors
  99. [99]

    D'Souza RS, Klasova J, Saini C et al.. “Global Burden of Complex Regional Pain Syndrome in At-Risk Populations: Estimates of Prevalence From 35 Countries Between 1993 and 2023.” Anesthesia and analgesia (2025). PMID: 39932867 ↗

    L2SR_OBSCited in: Epidemiology, Etiology and Risk Factors, Severity, Staging and Perioperative Risk Stratification, Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  100. [100]

    Droog W, Walbeehm ET, Konijn JB et al.. “A Systematic Review on Long-Term Postsurgical Pain Outcomes; What Is the Effect of Upper Extremity Regional Anesthesia?” Anesthesia and analgesia (2023). PMID: 37227939 ↗

    L2SR_OBSCited in: Epidemiology, Etiology and Risk Factors, Clinical Presentation, Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care, Acute Management and Crisis Pathways, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Regional and Interventional Procedures, Complications
  101. [101]

    Louis MH, Meyer C, Legrain V et al.. “Biological and psychological early prognostic factors in complex regional pain syndrome: A systematic review.” European journal of pain (London, England) (2022). PMID: 36516373 ↗

    L2SR_OBSCited in: Epidemiology, Etiology and Risk Factors, Clinical Presentation, Diagnosis and Workup, Severity, Staging and Perioperative Risk Stratification, Prognosis and Natural History
  102. [102]

    Pehora C, Pearson AM, Kaushal A et al.. “Dexamethasone as an adjuvant to peripheral nerve block.” The Cochrane database of systematic reviews (2017). PMID: 29121400 ↗

    L1SR_OBSCited in: Epidemiology, Etiology and Risk Factors, Clinical Presentation, Severity, Staging and Perioperative Risk Stratification, Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care, Acute Management and Crisis Pathways, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Regional and Interventional Procedures, Complications
  103. [103]

    Karantana A, Handoll HH, Sabouni A. “Percutaneous pinning for treating distal radial fractures in adults.” The Cochrane database of systematic reviews (2020). PMID: 32032439 ↗

    L1SR_OBSCited in: Epidemiology, Etiology and Risk Factors, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Complications
  104. [104]

    O'Connell NE, Wand BM, Gibson W et al.. “Local anaesthetic sympathetic blockade for complex regional pain syndrome.” The Cochrane database of systematic reviews (2016). PMID: 27467116 ↗

    L1SR_OBSCited in: Epidemiology, Etiology and Risk Factors, Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Regional and Interventional Procedures, Special Populations and Pregnancy
  105. [105]

    Stanton TR, Wand BM, Carr DB et al.. “Local anaesthetic sympathetic blockade for complex regional pain syndrome.” The Cochrane database of systematic reviews (2013). PMID: 23959684 ↗

    L1SR_OBSCited in: Epidemiology, Etiology and Risk Factors, Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Regional and Interventional Procedures, Special Populations and Pregnancy
  106. [106]

    Henschke N, Bergman H, Buckley BS et al.. “Effects of human papillomavirus (HPV) vaccination programmes on community rates of HPV-related disease and harms from vaccination.” The Cochrane database of systematic reviews (2025). PMID: 41276264 ↗

    L3SR_OBSCited in: Epidemiology, Etiology and Risk Factors, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Prevention, Screening and Surveillance
  107. [107]

    Awad G, Boutros M, Asmar C et al.. “Functional Bracing Versus Rigid Plaster Casting for the Immobilization of Colles Fractures in Adults: A Meta-Analysis of Randomized Controlled Trials.” Hand (New York, N.Y.) (2025). PMID: 41320967 ↗

    L1SR_MA_RCTCited in: Epidemiology, Etiology and Risk Factors
  108. [108]

    Lee HJ, Lee KH, Moon JY et al.. “Prevalence of autonomic nervous system dysfunction in complex regional pain syndrome.” Regional anesthesia and pain medicine (2021). PMID: 33419877 ↗

    L4OTHERCited in: Epidemiology, Etiology and Risk Factors, Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care, Regional and Interventional Procedures
  109. [109]

    Kim J, Rho H, Yoo Y et al.. “Clinical implication of regional osteopenia in complex regional pain syndrome: a retrospective comparative study.” Regional anesthesia and pain medicine (2026). PMID: 39961729 ↗

    L3OTHERCited in: Epidemiology, Etiology and Risk Factors, Diagnosis and Workup, Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care, Regional and Interventional Procedures, Complications, Special Populations and Pregnancy
  110. [110]

    Seretny M, Colvin LA. “Pain management in patients with vascular disease.” British journal of anaesthesia (2016). PMID: 27566812 ↗

    L5REVIEW_NARRATIVECited in: Epidemiology, Etiology and Risk Factors, Clinical Presentation, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Regional and Interventional Procedures, Complications
  111. [111]

    de Mos M, Huygen FJPM, Dieleman JP et al.. “Medical history and the onset of complex regional pain syndrome (CRPS).” Pain (2008). PMID: 18760877 ↗

    L3OTHERCited in: Epidemiology, Etiology and Risk Factors, History and Evolution of Treatment
  112. [112]

    Louis MH, Legrain V, Aron V et al.. “Complex regional pain syndrome evolution is determined by both biological and psychosocial factors: a 1-year prospective observational study.” Pain (2025). PMID: 41065599 ↗

    L2OTHERCited in: Epidemiology, Etiology and Risk Factors, Diagnosis and Workup, Severity, Staging and Perioperative Risk Stratification, History and Evolution of Treatment, Complications, Prognosis and Natural History, Special Populations and Pregnancy
  113. [113]

    de Mos M, de Bruijn AG, Huygen FJ et al.. “The incidence of complex regional pain syndrome: a population-based study.” Pain (2006). PMID: 17084977 ↗

    L3OTHERCited in: Epidemiology, Etiology and Risk Factors
  114. [114]

    van Rijn MA, Marinus J, Putter H et al.. “Onset and progression of dystonia in complex regional pain syndrome.” Pain (2007). PMID: 17499924 ↗

    L3OTHERCited in: Epidemiology, Etiology and Risk Factors
  115. [115]

    Nwosu C, Rodriguez K, Zeng S et al.. “Complications Following Volar Locking Plate Fixation of Distal Radius Fractures in Adults: A Systematic Review of Randomized Control Trials.” The Journal of hand surgery (2023). PMID: 37552141 ↗

    L1SR_OBSCited in: Epidemiology, Etiology and Risk Factors
  116. [116]

    Rteil A, Mzeihem M, Wang B et al.. “Association of Mental Health Disorders with Outcomes after Achilles Tendon Repair: A Propensity-Matched Cohort Study.” Orthopaedic journal of sports medicine (2026). PMID: 42256897 ↗

    L3COHORTCited in: Epidemiology, Etiology and Risk Factors, Complications
  117. [117]

    Berk A, Good L, Burkhart R et al.. “Patients with vitamin D deficiency are more likely to develop complex region pain syndrome after extremity fractures: a large database propensity-matched cohort study.” European journal of orthopaedic surgery & traumatology : orthopedie traumatologie (2025). PMID: 40913620 ↗

    L3COHORTCited in: Epidemiology, Etiology and Risk Factors, Special Populations and Pregnancy
  118. [118]

    Chan HA, Kapoor B, Rai Y et al.. “Spinal cord stimulation for chronic pain: a retrospective cohort study of patients from a Canadian tertiary centre.” Canadian journal of anaesthesia = Journal canadien d'anesthesie (2025). PMID: 40629235 ↗

    L3COHORTCited in: Epidemiology, Etiology and Risk Factors, Diagnosis and Workup, Regional and Interventional Procedures, Prognosis and Natural History, Special Populations and Pregnancy
  119. [119]

    Stavrakakis I, Sperelakis I, Zampetakis K et al.. “Outcomes and complications after open reduction and internal fixation of Lisfranc injuries: a retrospective cohort study.” European journal of orthopaedic surgery & traumatology : orthopedie traumatologie (2025). PMID: 40549015 ↗

    L3COHORTCited in: Epidemiology, Etiology and Risk Factors, Prognosis and Natural History, Special Populations and Pregnancy
  120. [120]

    Liu X, Guo J, Li Y et al.. “The impact of vitamin C supplementation on the perioperative outcomes after total hip and knee arthroplasty: a systematic review and meta-analysis.” BMC musculoskeletal disorders (2025). PMID: 41034912 ↗

    L1SR_OBSCited in: Epidemiology, Etiology and Risk Factors, Diagnosis and Workup
  121. [121]

    Ilfeld BM. “Continuous peripheral nerve blocks: a review of the published evidence.” Anesthesia and analgesia (2011). PMID: 21821511 ↗

    L5REVIEW_NARRATIVECited in: Epidemiology, Etiology and Risk Factors, Diagnosis and Workup, Severity, Staging and Perioperative Risk Stratification, Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care, Acute Management and Crisis Pathways, Regional and Interventional Procedures, Complications, Prognosis and Natural History
  122. [122]

    Zincirci DE, Çakır E, Atar S et al.. “Cross-education after forearm fracture: a randomised controlled trial.” Irish journal of medical science (2025). PMID: 41196520 ↗

    L1RCTCited in: Epidemiology, Etiology and Risk Factors, Diagnosis and Workup, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Special Populations and Pregnancy
  123. [123]

    Serôdio IN, Saiz-Vázquez O, Ortiz-Huerta H et al.. “Preventing Complex Regional Pain Syndrome After Distal Radius Fracture: A Systematic Review of Rehabilitation and Clinical Prophylaxis Strategies.” Journal of functional morphology and kinesiology (2026). PMID: 42029526 ↗

    L2SR_OBSCited in: Epidemiology, Etiology and Risk Factors
  124. [124]

    Speck V, Schlereth T, Birklein F et al.. “Increased prevalence of posttraumatic stress disorder in CRPS.” European journal of pain (London, England) (2016). PMID: 27650922 ↗

    L4OTHERCited in: Epidemiology, Etiology and Risk Factors, Severity, Staging and Perioperative Risk Stratification
  125. [125]

    Hall J, Llewellyn A, Palmer S et al.. “Sensorimotor dysfunction after limb fracture - An exploratory study.” European journal of pain (London, England) (2016). PMID: 26996877 ↗

    L4OTHERCited in: Epidemiology, Etiology and Risk Factors
  126. [126]

    Louis MH, Legrain V, Aron V et al.. “Early CRPS Is a Heterogeneous Condition: Results From a Latent Class Analysis.” European journal of pain (London, England) (2025). PMID: 39825738 ↗

    L4OTHERCited in: Epidemiology, Etiology and Risk Factors
  127. [127]

    de Boer RD, Marinus J, van Hilten JJ et al.. “Distribution of signs and symptoms of complex regional pain syndrome type I in patients meeting the diagnostic criteria of the International Association for the Study of Pain.” European journal of pain (London, England) (2011). PMID: 21334934 ↗

    L4OTHERCited in: Epidemiology, Etiology and Risk Factors
  128. [128]

    Cohen H, McCabe C, Harris N et al.. “Clinical evidence of parietal cortex dysfunction and correlation with extent of allodynia in CRPS type 1.” European journal of pain (London, England) (2012). PMID: 23132624 ↗

    L4OTHERCited in: Epidemiology, Etiology and Risk Factors, Severity, Staging and Perioperative Risk Stratification
  129. [129]

    Ranjbar Moghaddam M, Nasiri-Formi E, Merajikhah A. “Efficacy of vitamin C supplementation in preventing and treating complex regional pain syndrome type I (CRPS-I) in Orthopedic patients: A systematic review and meta-analysis.” International journal of orthopaedic and trauma nursing (2024). PMID: 39447383 ↗

    L1SR_OBSCited in: Epidemiology, Etiology and Risk Factors
  130. [130]

    Kaya S, Dursun MA, Karabak B et al.. “Risk factors for complex regional pain syndrome after distal radius fracture following nonoperative management: A retrospective case-control study.” Injury (2025). PMID: 41082853 ↗

    L3CASE_CONTROLCited in: Epidemiology, Etiology and Risk Factors
  131. [131]

    Terkelsen AJ, Bach FW, Jensen TS. “Experimental forearm immobilization in humans induces cold and mechanical hyperalgesia.” Anesthesiology (2008). PMID: 18648239 ↗

    L2TRIAL_NONRANDOMCited in: Clinical Presentation, Diagnosis and Workup
  132. [132]

    Pang D, Royds J, Goebel A. “Immunological Therapy in Persistent Complex Regional Pain Syndrome: A Systematic Review and Narrative Synthesis.” European journal of pain (London, England) (2025). PMID: 41199694 ↗

    L2SR_OBSCited in: Clinical Presentation, Complications
  133. [133]

    Acapo S, Osinski T, Rulleau T et al.. “Assessment of body perception disturbances in complex regional pain syndrome: A systematic review using the COSMIN guideline.” European journal of pain (London, England) (2022). PMID: 36065635 ↗

    L2SR_OBSCited in: Clinical Presentation
  134. [134]

    Hurst LC, Badalamente MA, Hentz VR et al.. “Injectable collagenase clostridium histolyticum for Dupuytren's contracture.” The New England journal of medicine (2009). PMID: 19726771 ↗

    L1RCTCited in: Clinical Presentation, Diagnosis and Workup, History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Complications, Prognosis and Natural History
  135. [135]

    Forero M, Kamel RA, Chan PL et al.. “Two years follow-up of continuous erector spinae plane block in a patient with upper extremity complex regional pain syndrome type I.” Regional anesthesia and pain medicine (2022). PMID: 35396336 ↗

    L4CASE_REPORTCited in: Clinical Presentation, Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Regional and Interventional Procedures, Complications
  136. [136]

    Ferraro MC, Cashin AG, Wand BM et al.. “Interventions for treating pain and disability in adults with complex regional pain syndrome- an overview of systematic reviews.” The Cochrane database of systematic reviews (2023). PMID: 37306570 ↗

    L2SR_OBSCited in: Clinical Presentation, Complications
  137. [137]

    Wajon A, Carr E, Edmunds I et al.. “Surgery for thumb (trapeziometacarpal joint) osteoarthritis.” The Cochrane database of systematic reviews (2009). PMID: 19821330 ↗

    L1SR_OBSCited in: Clinical Presentation, Diagnosis and Workup, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Complications
  138. [138]

    Tajerian M, Leu D, Zou Y et al.. “Brain neuroplastic changes accompany anxiety and memory deficits in a model of complex regional pain syndrome.” Anesthesiology (2014). PMID: 25093591 ↗

    L5OTHERCited in: Clinical Presentation, Complications
  139. [139]

    Das V, Kroin JS, Moric M et al.. “Biochemical and Pharmacological Characterization of a Mice Model of Complex Regional Pain Syndrome.” Regional anesthesia and pain medicine (2017). PMID: 28609318 ↗

    L5OTHERCited in: Clinical Presentation, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Complications
  140. [140]

    Provenzano DA, Heller JA. “Daring discourse: economics of neuromodulation for the treatment of persistent spinal pain syndrome and complex regional pain syndrome.” Regional anesthesia and pain medicine (2023). PMID: 37080579 ↗

    L5OTHERCited in: Clinical Presentation, Diagnosis and Workup, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Regional and Interventional Procedures, Complications, Prognosis and Natural History
  141. [141]

    Iolascon G, Franchi M, Bernetti A et al.. “SIMFER guidelines on physical modalities for chronic primary pain management.” European journal of physical and rehabilitation medicine (2026). PMID: 42262745 ↗

    L1GUIDELINECited in: Clinical Presentation, History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Complications
  142. [142]

    Chung K, Kim KH, Kim ED. “Perfusion index as a reliable parameter of vasomotor disturbance in complex regional pain syndrome.” British journal of anaesthesia (2018). PMID: 30336858 ↗

    L3OTHERCited in: Clinical Presentation, Diagnosis and Workup, Special Populations and Pregnancy
  143. [143]

    Drummond PD, Finch PM. “Auditory disturbances in patients with complex regional pain syndrome.” Pain (2022). PMID: 36036917 ↗

    L3OTHERCited in: Clinical Presentation
  144. [144]

    Drummond PD, Morellini N, Finch PM et al.. “Complex regional pain syndrome: intradermal injection of phenylephrine evokes pain and hyperalgesia in a subgroup of patients with upregulated α1-adrenoceptors on dermal nerves.” Pain (2018). PMID: 29994991 ↗

    L3OTHERCited in: Clinical Presentation
  145. [145]

    Butchart AG, Mathews M, Surendran A. “Complex regional pain syndrome following protracted labour*.” Anaesthesia (2012). PMID: 22881282 ↗

    L4CASE_REPORTCited in: Clinical Presentation, Diagnosis and Workup, Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Regional and Interventional Procedures, Complications, Special Populations and Pregnancy
  146. [146]

    Goebel A, Barker C, Birklein F et al.. “Standards for the diagnosis and management of complex regional pain syndrome: Results of a European Pain Federation task force.” European journal of pain (London, England) (2019). PMID: 30620109 ↗

    L1GUIDELINECited in: Diagnosis and Workup, History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Prevention, Screening and Surveillance
  147. [147]

    Munts AG, van der Plas AA, Voormolen JH et al.. “Intrathecal glycine for pain and dystonia in complex regional pain syndrome.” Pain (2009). PMID: 19683392 ↗

    L4RCTCited in: Diagnosis and Workup, History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Prognosis and Natural History
  148. [148]

    Cossins L, Okell RW, Cameron H et al.. “Treatment of complex regional pain syndrome in adults: a systematic review of randomized controlled trials published from June 2000 to February 2012.” European journal of pain (London, England) (2012). PMID: 23042687 ↗

    L1SR_MA_RCTCited in: Diagnosis and Workup, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Prognosis and Natural History
  149. [149]

    Cheng J, Salmasi V, You J et al.. “Outcomes of Sympathetic Blocks in the Management of Complex Regional Pain Syndrome: A Retrospective Cohort Study.” Anesthesiology (2019). PMID: 31365367 ↗

    L2COHORTCited in: Diagnosis and Workup, Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care, Regional and Interventional Procedures, Prognosis and Natural History
  150. [150]

    Grieve S, Jones L, Walsh N et al.. “What outcome measures are commonly used for Complex Regional Pain Syndrome clinical trials? A systematic review of the literature.” European journal of pain (London, England) (2015). PMID: 26075938 ↗

    L2TRIAL_NONRANDOMCited in: Diagnosis and Workup, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Prognosis and Natural History
  151. [151]

    Vasiliadis HS, Georgoulas P, Shrier I et al.. “Endoscopic release for carpal tunnel syndrome.” The Cochrane database of systematic reviews (2014). PMID: 24482073 ↗

    L1SR_OBSCited in: Diagnosis and Workup, Severity, Staging and Perioperative Risk Stratification, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Complications, Prognosis and Natural History
  152. [152]

    Zernikow B, Wager J, Brehmer H et al.. “Invasive treatments for complex regional pain syndrome in children and adolescents: a scoping review.” Anesthesiology (2015). PMID: 25539076 ↗

    L5REVIEW_NARRATIVECited in: Diagnosis and Workup, Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Regional and Interventional Procedures, Prognosis and Natural History, Special Populations and Pregnancy
  153. [153]

    Shi X, Guo TZ, Li W et al.. “Exercise Reverses Nociceptive Sensitization, Upregulated Neuropeptide Signaling, Inflammatory Changes, Anxiety, and Memory Impairment in a Mouse Tibia Fracture Model.” Anesthesiology (2018). PMID: 29994924 ↗

    L5OTHERCited in: Diagnosis and Workup
  154. [154]

    Moon JY, Park SY, Kim YC et al.. “Analysis of patterns of three-phase bone scintigraphy for patients with complex regional pain syndrome diagnosed using the proposed research criteria (the 'Budapest Criteria').” British journal of anaesthesia (2012). PMID: 22293544 ↗

    L3OTHERCited in: Diagnosis and Workup
  155. [155]

    Muwanga GPB, Tena AC, Pang A et al.. “Ethological profiling defines pain behaviors and parses analgesia from drug side effects in a mouse model of complex regional pain syndrome.” Pain (2026). PMID: 42133564 ↗

    L5OTHERCited in: Diagnosis and Workup, Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  156. [156]

    Mesaroli G, Davis AM, Perruccio AV et al.. “Reliability and validity of the Pediatric PainSCAN: a screening tool for pediatric neuropathic pain and complex regional pain syndrome.” Pain (2025). PMID: 40623293 ↗

    L2OTHERCited in: Diagnosis and Workup, Severity, Staging and Perioperative Risk Stratification, Special Populations and Pregnancy
  157. [157]

    Harden NR, Bruehl S, Perez RSGM et al.. “Development of a severity score for CRPS.” Pain (2010). PMID: 20965657 ↗

    L3OTHERCited in: Diagnosis and Workup, Severity, Staging and Perioperative Risk Stratification
  158. [158]

    Gierthmühlen J, Maier C, Baron R et al.. “Sensory signs in complex regional pain syndrome and peripheral nerve injury.” Pain (2011). PMID: 22154921 ↗

    L3OTHERCited in: Diagnosis and Workup, Special Populations and Pregnancy
  159. [159]

    Henzi A, Schneider S, Sutter R et al.. “MRI has limited accuracy in diagnosing complex regional pain syndrome Type 1 - a systematic review of the literature.” European journal of radiology (2025). PMID: 41223627 ↗

    L2SR_OBSCited in: Diagnosis and Workup
  160. [160]

    Buccilli B, Mohammed N, Mohammed D et al.. “Maternal and fetal outcomes of spinal cord stimulation in pregnancy: systematic review with descriptive meta-analysis.” Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia (2026). PMID: 42235384 ↗

    L2SR_OBSCited in: Diagnosis and Workup, Regional and Interventional Procedures, Special Populations and Pregnancy
  161. [161]

    Niehof SP, Beerthuizen A, Huygen FJ et al.. “Using skin surface temperature to differentiate between complex regional pain syndrome type 1 patients after a fracture and control patients with various complaints after a fracture.” Anesthesia and analgesia (2008). PMID: 18165590 ↗

    L3OTHERCited in: Diagnosis and Workup, Special Populations and Pregnancy
  162. [162]

    Wesseldijk F, Fekkes D, Huygen FJ et al.. “Increased plasma serotonin in complex regional pain syndrome type 1.” Anesthesia and analgesia (2008). PMID: 18499624 ↗

    L3OTHERCited in: Diagnosis and Workup
  163. [163]

    Lamé IE, Peters ML, Patijn J et al.. “Can the outcome of spinal cord stimulation in chronic complex regional pain syndrome type I patients be predicted by catastrophizing thoughts?” Anesthesia and analgesia (2009). PMID: 19608836 ↗

    L2OTHERCited in: Diagnosis and Workup, Regional and Interventional Procedures, Prognosis and Natural History
  164. [164]

    Shi X, Wang L, Li X et al.. “Neuropeptides contribute to peripheral nociceptive sensitization by regulating interleukin-1β production in keratinocytes.” Anesthesia and analgesia (2011). PMID: 21596883 ↗

    L5OTHERCited in: Diagnosis and Workup
  165. [165]

    Bernateck M, Karst M, Gratz KF et al.. “The first scintigraphic detection of tumor necrosis factor-alpha in patients with complex regional pain syndrome type 1.” Anesthesia and analgesia (2009). PMID: 19910617 ↗

    L4OTHERCited in: Diagnosis and Workup
  166. [166]

    Khoramdel F, Ravanbod R, Akbari H. “Effect of high-intensity laser therapy and mirror therapy on complex regional pain syndrome type I in the hand area: A randomized controlled trial.” Journal of hand therapy : official journal of the American Society of Hand Therapists (2025). PMID: 40118675 ↗

    L1RCTCited in: Diagnosis and Workup, Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  167. [167]

    Grieve S, Llewellyn A, Jones L et al.. “Complex regional pain syndrome: An international survey of clinical practice.” European journal of pain (London, England) (2019). PMID: 31376299 ↗

    L2OTHERCited in: Diagnosis and Workup, Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  168. [168]

    Reinhold AK, Kindl GK, Dietz C et al.. “Molecular and clinical markers of pain relief in complex regional pain syndrome: An observational study.” European journal of pain (London, England) (2022). PMID: 36440973 ↗

    L2OTHERCited in: Diagnosis and Workup, Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  169. [169]

    Meyer-Frießem CH, Attal N, Baron R et al.. “Pain thresholds and intensities of CRPS type I and neuropathic pain in respect to sex.” European journal of pain (London, England) (2020). PMID: 32096888 ↗

    L3OTHERCited in: Diagnosis and Workup
  170. [170]

    Halicka M, Vittersø AD, McCullough H et al.. “Prism adaptation treatment for upper-limb complex regional pain syndrome: a double-blind randomized controlled trial.” Pain (2021). PMID: 32833791 ↗

    L1RCTCited in: Severity, Staging and Perioperative Risk Stratification, History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  171. [171]

    van Rijn MA, Munts AG, Marinus J et al.. “Intrathecal baclofen for dystonia of complex regional pain syndrome.” Pain (2009). PMID: 19232828 ↗

    L2RCTCited in: Severity, Staging and Perioperative Risk Stratification, Prognosis and Natural History
  172. [172]

    Bean DJ, Johnson MH, Heiss-Dunlop W et al.. “Do psychological factors influence recovery from complex regional pain syndrome type 1? A prospective study.” Pain (2015). PMID: 26133727 ↗

    L2COHORTCited in: Severity, Staging and Perioperative Risk Stratification
  173. [173]

    Bean DJ, Johnson MH, Heiss-Dunlop W et al.. “Extent of recovery in the first 12 months of complex regional pain syndrome type-1: A prospective study.” European journal of pain (London, England) (2015). PMID: 26524108 ↗

    L2COHORTCited in: Severity, Staging and Perioperative Risk Stratification, Prognosis and Natural History
  174. [174]

    Kim JY, Yoon SY, Kim J et al.. “Neural substrates for poststroke complex regional pain syndrome type I: a retrospective case-control study using voxel-based lesion symptom mapping analysis.” Pain (2020). PMID: 31985589 ↗

    L3CASE_CONTROLCited in: Severity, Staging and Perioperative Risk Stratification
  175. [175]

    van der Spek DP, Ghantous J, Hagenaars T et al.. “Long-term outcomes of amputation in patients with complex regional pain syndrome (CRPS): a mixed-methods study.” Regional anesthesia and pain medicine (2025). PMID: 40819917 ↗

    L4OTHERCited in: Severity, Staging and Perioperative Risk Stratification, Complications, Prognosis and Natural History
  176. [176]

    Harden RN, Maihofner C, Abousaad E et al.. “A prospective, multisite, international validation of the Complex Regional Pain Syndrome Severity Score.” Pain (2017). PMID: 28715350 ↗

    L4OTHERCited in: Severity, Staging and Perioperative Risk Stratification
  177. [177]

    van Velzen GAJ, Perez RSGM, van Gestel MA et al.. “Health-related quality of life in 975 patients with complex regional pain syndrome type 1.” Pain (2013). PMID: 24342465 ↗

    L4OTHERCited in: Severity, Staging and Perioperative Risk Stratification
  178. [178]

    Krumova EK, Frettlöh J, Klauenberg S et al.. “Long-term skin temperature measurements - a practical diagnostic tool in complex regional pain syndrome.” Pain (2008). PMID: 18723287 ↗

    L4OTHERCited in: Severity, Staging and Perioperative Risk Stratification
  179. [179]

    Reinersmann A, Landwehrt J, Krumova EK et al.. “Impaired spatial body representation in complex regional pain syndrome type 1 (CRPS I).” Pain (2012). PMID: 22841878 ↗

    L3OTHERCited in: Severity, Staging and Perioperative Risk Stratification
  180. [180]

    Grieve S, Perez RSGM, Birklein F et al.. “Recommendations for a first Core Outcome Measurement set for complex regional PAin syndrome Clinical sTudies (COMPACT).” Pain (2017). PMID: 28178071 ↗

    L5OTHERCited in: Severity, Staging and Perioperative Risk Stratification
  181. [181]

    Lee CH, Lee BG, Kim JH et al.. “Complications and outcomes of operative treatment for acute perilunate injuries: a systematic review.” The Journal of hand surgery, European volume (2023). PMID: 36708152 ↗

    L1SR_OBSCited in: Severity, Staging and Perioperative Risk Stratification
  182. [182]

    Kalita J, Shukla R, Pandey PC. “Effect of Prednisolone on Clinical and Cytokine mRNA Profiling in Complex Regional Pain Syndrome.” Journal of molecular neuroscience : MN (2024). PMID: 39633155 ↗

    L4RCTCited in: Severity, Staging and Perioperative Risk Stratification, History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  183. [183]

    Qiu X, Gao T, Hua Y et al.. “Efficacy of manual lymphatic drainage combined with repetitive transcranial magnetic stimulation in post-stroke complex regional pain syndrome: a pilot study.” Disability and rehabilitation (2024). PMID: 39417484 ↗

    L1RCTCited in: Severity, Staging and Perioperative Risk Stratification, History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  184. [184]

    Schneider S, Wertli MM, Henzi A et al.. “Effect of an interdisciplinary inpatient program for patients with complex regional pain syndrome in reducing disease activity-a single-center prospective cohort study.” Pain medicine (Malden, Mass.) (2024). PMID: 38530793 ↗

    L4COHORTCited in: Severity, Staging and Perioperative Risk Stratification
  185. [185]

    van den Berg C, Huygen FJPM, Tiemensma J. “The efficacy of oral corticoids in treating complex regional pain syndrome: A retrospective cohort study.” Pain practice : the official journal of World Institute of Pain (2023). PMID: 37882378 ↗

    L2COHORTCited in: Severity, Staging and Perioperative Risk Stratification
  186. [186]

    Wertli MM, Aegler B, McCabe CS et al.. “Resilience in patients with complex regional pain syndrome 1-a cross-sectional analysis of patients participating in a cross-sectional cohort study.” Pain medicine (Malden, Mass.) (2023). PMID: 37154698 ↗

    L4COHORTCited in: Severity, Staging and Perioperative Risk Stratification
  187. [187]

    Ratcliffe S, Arkilo D, Asgharnejad M et al.. “Randomized controlled study to evaluate the efficacy and safety of soticlestat as adjunctive therapy in adults with complex regional pain syndrome.” Pain medicine (Malden, Mass.) (2023). PMID: 36538782 ↗

    L1RCTCited in: Severity, Staging and Perioperative Risk Stratification
  188. [188]

    Fallico N, Padmanabhan R, Rahman S et al.. “A randomised placebo-controlled clinical trial on the efficacy of local lidocaine injections and oral citalopram for the treatment of complex regional pain syndrome.” Journal of plastic, reconstructive & aesthetic surgery : JPRAS (2021). PMID: 34903493 ↗

    L1RCTCited in: Severity, Staging and Perioperative Risk Stratification
  189. [189]

    Siegel SM, Lee JW, Oaklander AL. “Needlestick distal nerve injury in rats models symptoms of complex regional pain syndrome.” Anesthesia and analgesia (2007). PMID: 18042888 ↗

    L5OTHERCited in: Severity, Staging and Perioperative Risk Stratification
  190. [190]

    Klein MM, Lee JW, Siegel SM et al.. “Endoneurial pathology of the needlestick-nerve-injury model of Complex Regional Pain Syndrome, including rats with and without pain behaviors.” European journal of pain (London, England) (2012). PMID: 21676634 ↗

    L5OTHERCited in: Severity, Staging and Perioperative Risk Stratification
  191. [191]

    Karpin H, Vatine JJ, Livshitz A et al.. “A Model of Body Perception Disturbances in Chronic Limb Pain: The Predictive Role of Kinesiophobia, Depersonalization and Symptom Severity.” European journal of pain (London, England) (2025). PMID: 40922473 ↗

    L4OTHERCited in: Severity, Staging and Perioperative Risk Stratification
  192. [192]

    Yoo Y, Lee CS, Kim J et al.. “Botulinum Toxin Type A for Lumbar Sympathetic Ganglion Block in Complex Regional Pain Syndrome: A Randomized Trial.” Anesthesiology (2022). PMID: 34890455 ↗

    L1RCTCited in: Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care, History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Regional and Interventional Procedures
  193. [193]

    Manjunath PS, Jayalakshmi TS, Dureja GP et al.. “Management of lower limb complex regional pain syndrome type 1: an evaluation of percutaneous radiofrequency thermal lumbar sympathectomy versus phenol lumbar sympathetic neurolysis--a pilot study.” Anesthesia and analgesia (2008). PMID: 18227328 ↗

    L1RCTCited in: Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care, History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Regional and Interventional Procedures, Special Populations and Pregnancy
  194. [194]

    Young AC, Lubenow TR, Buvanendran A. “The parturient with implanted spinal cord stimulator: management and review of the literature.” Regional anesthesia and pain medicine (2015). PMID: 25899957 ↗

    L4CASE_REPORTCited in: Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care, Regional and Interventional Procedures, Special Populations and Pregnancy
  195. [195]

    Bernateck M, Rolke R, Birklein F et al.. “Successful intravenous regional block with low-dose tumor necrosis factor-alpha antibody infliximab for treatment of complex regional pain syndrome 1.” Anesthesia and analgesia (2007). PMID: 17898403 ↗

    L4CASE_REPORTCited in: Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care, Regional and Interventional Procedures
  196. [196]

    Nordmann GR, Lauder GR, Grier DJ. “Computed tomography guided lumbar sympathetic block for complex regional pain syndrome in a child: a case report and review.” European journal of pain (London, England) (2005). PMID: 15979912 ↗

    L4CASE_REPORTCited in: Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care, Regional and Interventional Procedures
  197. [197]

    O'Connell NE, Wand BM, McAuley J et al.. “Interventions for treating pain and disability in adults with complex regional pain syndrome.” The Cochrane database of systematic reviews (2013). PMID: 23633371 ↗

    L1SR_OBSCited in: Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Regional and Interventional Procedures
  198. [198]

    Heikkinen N, Nietosvaara Y, Reito A et al.. “Carpal tunnel release under local anesthesia with or without distal median nerve block: Double-blind randomized clinical trial.” Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society (2024). PMID: 39297416 ↗

    L1TRIAL_NONRANDOMCited in: Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care
  199. [199]

    Kim YH, Kim SY, Lee YJ et al.. “A Prospective, Randomized Cross-Over Trial of T2 Paravertebral Block as a Sympathetic Block in Complex Regional Pain Syndrome.” Pain physician (2019). PMID: 31561653 ↗

    L1TRIAL_NONRANDOMCited in: Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care
  200. [200]

    Tian Y, Hu Y, Hu T et al.. “Stellate Ganglion Block Therapy for Complex Regional Pain Syndrome: A Systematic Review and Meta-Analysis.” Pain physician (2024). PMID: 38805523 ↗

    L1SR_OBSCited in: Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care
  201. [201]

    Rajagopalan V, Chouhan RS, Pandia MP et al.. “Effect of Stellate Ganglion Block on Intraoperative Propofol and Fentanyl Consumption in Patients with Complex Regional Pain Syndrome Undergoing Surgical Repair of Brachial Plexus Injury: A Randomized, Double-blind, Placebo-controlled Trial.” Neurology India (2020). PMID: 32643674 ↗

    L1RCTCited in: Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care
  202. [202]

    Dev S, Yoo Y, Lee HJ et al.. “Does Temperature Increase by Sympathetic Neurolysis Improve Pain in Complex Regional Pain Syndrome? A Retrospective Cohort Study.” World neurosurgery (2017). PMID: 29107167 ↗

    L2COHORTCited in: Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care
  203. [203]

    Fajardo Pérez M, Yamak-Altinpulluk E, Díez Tafur R et al.. “Novel ultrasound-guided supraclavicular stellate ganglion block.” Pain practice : the official journal of World Institute of Pain (2024). PMID: 38251786 ↗

    L4CASE_REPORTCited in: Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care
  204. [204]

    Ramos PR, Sakata RK, Ribeiro HC et al.. “A prospective, comparative study of the analgesic effect between the WALANT technique and local anesthesia associated with sedation for hand surgery.” Acta cirurgica brasileira (2023). PMID: 37909593 ↗

    L1RCTCited in: Perioperative Anesthetic Conduct: Airway Management, Technique Selection and Intraoperative Care
  205. [205]

    Perez RS, Pragt E, Geurts J et al.. “Treatment of patients with complex regional pain syndrome type I with mannitol: a prospective, randomized, placebo-controlled, double-blinded study.” The journal of pain (2008). PMID: 18403271 ↗

    L1RCTCited in: Acute Management and Crisis Pathways
  206. [206]

    Arai T, Kashimoto Y, Ukyo Y et al.. “Two placebo-controlled, randomized withdrawal studies to evaluate the fentanyl 1 day patch in opioid-naïve patients with chronic pain.” Current medical research and opinion (2015). PMID: 26359327 ↗

    L1RCTCited in: Acute Management and Crisis Pathways
  207. [207]

    da Costa VV, de Oliveira SB, Fernandes Mdo C et al.. “Incidence of regional pain syndrome after carpal tunnel release. Is there a correlation with the anesthetic technique?” Revista brasileira de anestesiologia (2011). PMID: 21724005 ↗

    L2RCTCited in: Acute Management and Crisis Pathways
  208. [208]

    Narouze S, Vydyanathan A, Patel N. “Ultrasound-guided stellate ganglion block successfully prevented esophageal puncture.” Pain physician (2007). PMID: 17987096 ↗

    L4CASE_REPORTCited in: Acute Management and Crisis Pathways
  209. [209]

    Lopez WO, Barbosa DC, Teixera MJ et al.. “Pain Relief in CRPS-II after Spinal Cord and Motor Cortex Simultaneous Dual Stimulation.” Pain physician (2016). PMID: 27228530 ↗

    L4CASE_REPORTCited in: Acute Management and Crisis Pathways
  210. [210]

    Elkoundi A, Eloukkal Z, Bensghir M et al.. “Priapism following erector spinae plane block for the treatment of a complex regional pain syndrome.” The American journal of emergency medicine (2019). PMID: 30660341 ↗

    L4CASE_REPORTCited in: Acute Management and Crisis Pathways
  211. [211]

    Wallace MS, Ridgeway BM, Leung AY et al.. “Concentration-effect relationship of intravenous lidocaine on the allodynia of complex regional pain syndrome types I and II.” Anesthesiology (2000). PMID: 10638902 ↗

    L1RCTCited in: History and Evolution of Treatment
  212. [212]

    Kemler MA, Reulen JP, Barendse GA et al.. “Impact of spinal cord stimulation on sensory characteristics in complex regional pain syndrome type I: a randomized trial.” Anesthesiology (2001). PMID: 11465587 ↗

    L1RCTCited in: History and Evolution of Treatment
  213. [213]

    Taskaynatan MA, Ozgul A, Tan AK et al.. “Bier block with methylprednisolone and lidocaine in CRPS type I: a randomized, double-blinded, placebo-controlled study.” Regional anesthesia and pain medicine (2004). PMID: 15372383 ↗

    L1RCTCited in: History and Evolution of Treatment
  214. [214]

    Moseley GL. “Graded motor imagery is effective for long-standing complex regional pain syndrome: a randomised controlled trial.” Pain (2004). PMID: 15109523 ↗

    L1RCTCited in: History and Evolution of Treatment
  215. [215]

    Dubuis E, Thompson V, Leite MI et al.. “Longstanding complex regional pain syndrome is associated with activating autoantibodies against alpha-1a adrenoceptors.” Pain (2014). PMID: 25250722 ↗

    L3RCTCited in: History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  216. [216]

    Gustin SM, Schwarz A, Birbaumer N et al.. “NMDA-receptor antagonist and morphine decrease CRPS-pain and cerebral pain representation.” Pain (2010). PMID: 20630656 ↗

    L1RCTCited in: History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Special Populations and Pregnancy
  217. [217]

    Borgeat A, Ekatodramis G, Kalberer F et al.. “Acute and nonacute complications associated with interscalene block and shoulder surgery: a prospective study.” Anesthesiology (2001). PMID: 11605927 ↗

    L2TRIAL_NONRANDOMCited in: History and Evolution of Treatment
  218. [218]

    Harke H, Gretenkort P, Ladleif HU et al.. “The response of neuropathic pain and pain in complex regional pain syndrome I to carbamazepine and sustained-release morphine in patients pretreated with spinal cord stimulation: a double-blinded randomized study.” Anesthesia and analgesia (2001). PMID: 11159256 ↗

    L1RCTCited in: History and Evolution of Treatment
  219. [219]

    Lewis JS, Newport R, Taylor G et al.. “Visual illusions modulate body perception disturbance and pain in Complex Regional Pain Syndrome: A randomized trial.” European journal of pain (London, England) (2021). PMID: 33759278 ↗

    L1RCTCited in: History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  220. [220]

    Munts AG, van der Plas AA, Ferrari MD et al.. “Efficacy and safety of a single intrathecal methylprednisolone bolus in chronic complex regional pain syndrome.” European journal of pain (London, England) (2009). PMID: 20018535 ↗

    L1RCTCited in: History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Regional and Interventional Procedures, Prognosis and Natural History
  221. [221]

    Almog S, Aharon-Peretz J, Vulfsons S et al.. “The pharmacokinetics, efficacy, and safety of a novel selective-dose cannabis inhaler in patients with chronic pain: A randomized, double-blinded, placebo-controlled trial.” European journal of pain (London, England) (2020). PMID: 32445190 ↗

    L1RCTCited in: History and Evolution of Treatment, Complications
  222. [222]

    Hegelmaier T, Kumowski N, Mainka T et al.. “Remote ischaemic conditioning decreases blood flow and improves oxygen extraction in patients with early complex regional pain syndrome.” European journal of pain (London, England) (2017). PMID: 28340289 ↗

    L2RCTCited in: History and Evolution of Treatment
  223. [223]

    Kriek N, Groeneweg JG, Stronks DL et al.. “Preferred frequencies and waveforms for spinal cord stimulation in patients with complex regional pain syndrome: A multicentre, double-blind, randomized and placebo-controlled crossover trial.” European journal of pain (London, England) (2016). PMID: 27714945 ↗

    L1RCTCited in: History and Evolution of Treatment, Regional and Interventional Procedures
  224. [224]

    Dahan A, Olofsen E, Sigtermans M et al.. “Population pharmacokinetic-pharmacodynamic modeling of ketamine-induced pain relief of chronic pain.” European journal of pain (London, England) (2010). PMID: 20638877 ↗

    L1RCTCited in: History and Evolution of Treatment
  225. [225]

    Kemler MA, Barendse GA, van Kleef M et al.. “Spinal cord stimulation in patients with chronic reflex sympathetic dystrophy.” The New England journal of medicine (2000). PMID: 10965008 ↗

    L1RCTCited in: History and Evolution of Treatment
  226. [226]

    van Hilten BJ, van de Beek WJ, Hoff JI et al.. “Intrathecal baclofen for the treatment of dystonia in patients with reflex sympathetic dystrophy.” The New England journal of medicine (2000). PMID: 10965009 ↗

    L1RCTCited in: History and Evolution of Treatment
  227. [227]

    Stanton-Hicks M, Jänig W, Hassenbusch S et al.. “Reflex sympathetic dystrophy: changing concepts and taxonomy.” Pain (1995). PMID: 8577483 ↗

    L5REVIEW_NARRATIVECited in: History and Evolution of Treatment
  228. [228]

    Allen G, Galer BS, Schwartz L. “Epidemiology of complex regional pain syndrome: a retrospective chart review of 134 patients.” Pain (1999). PMID: 10342415 ↗

    L4REVIEW_NARRATIVECited in: History and Evolution of Treatment
  229. [229]

    Ahmed SU. “Complex regional pain syndrome type I after myocardial infarction treated with spinal cord stimulation.” Regional anesthesia and pain medicine (2003). PMID: 12772144 ↗

    L4CASE_REPORTCited in: History and Evolution of Treatment
  230. [230]

    Buchheit T, Crews JC. “Lateral cervical epidural catheter placement for continuous unilateral upper extremity analgesia and sympathetic block.” Regional anesthesia and pain medicine (2000). PMID: 10834791 ↗

    L4CASE_REPORTCited in: History and Evolution of Treatment
  231. [231]

    Berry JD, Rowbotham MC, Petersen KL. “Complex regional pain syndrome-like symptoms during herpes zoster.” Pain (2004). PMID: 15275746 ↗

    L2OTHERCited in: History and Evolution of Treatment
  232. [232]

    Brown CA, Scholtes I, Shenker N et al.. “Suboptimal learning of tactile-spatial predictions in patients with complex regional pain syndrome.” Pain (2020). PMID: 31651574 ↗

    L3OTHERCited in: History and Evolution of Treatment
  233. [233]

    Ahmed SU, Vallejo R, Hord ED. “Seizures after a Bier block with clonidine and lidocaine.” Anesthesia and analgesia (2004). PMID: 15271746 ↗

    L4CASE_REPORTCited in: History and Evolution of Treatment
  234. [234]

    Parisod E, Murray RF, Cousins MJ. “Conversion disorder after implant of a spinal cord stimulator in a patient with a complex regional pain syndrome.” Anesthesia and analgesia (2003). PMID: 12505953 ↗

    L4CASE_REPORTCited in: History and Evolution of Treatment
  235. [235]

    Stegeman M, Pruijn N, Susan S et al.. “Open versus arthroscopic fusion of the subtalar joint: a randomized controlled trial.” Acta orthopaedica (2024). PMID: 39656213 ↗

    L1RCTCited in: History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  236. [236]

    Özdemir EC, Elhan AH, Küçükdeveci AA. “Effects of mirror therapy in post-traumatic complex regional pain syndrome type-1: a randomized controlled study.” Journal of rehabilitation medicine (2024). PMID: 39318174 ↗

    L1RCTCited in: History and Evolution of Treatment, Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  237. [237]

    Olsson GL, Meyerson BA, Linderoth B. “Spinal cord stimulation in adolescents with complex regional pain syndrome type I (CRPS-I).” European journal of pain (London, England) (2007). PMID: 17889577 ↗

    L4CASE_REPORTCited in: History and Evolution of Treatment, Regional and Interventional Procedures, Special Populations and Pregnancy
  238. [238]

    Dijkstra PU, Groothoff JW, ten Duis HJ et al.. “Incidence of complex regional pain syndrome type I after fractures of the distal radius.” European journal of pain (London, England) (2003). PMID: 12935798 ↗

    L2OTHERCited in: History and Evolution of Treatment
  239. [239]

    Brunner F, Lienhardt SB, Kissling RO et al.. “Diagnostic criteria and follow-up parameters in complex regional pain syndrome type I--a Delphi survey.” European journal of pain (London, England) (2007). PMID: 17400492 ↗

    L5OTHERCited in: History and Evolution of Treatment
  240. [240]

    Velasco F, Carrillo-Ruiz JD, Castro G et al.. “Motor cortex electrical stimulation applied to patients with complex regional pain syndrome.” Pain (2009). PMID: 19793621 ↗

    L4RCTCited in: Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  241. [241]

    Broadbent P, Liossi C, Schoth DE. “Attentional bias to somatosensory stimuli in chronic pain patients: a systematic review and meta-analysis.” Pain (2021). PMID: 32833792 ↗

    L1SR_OBSCited in: Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Complications
  242. [242]

    Xu J, Yang J, Lin P et al.. “Intravenous Therapies for Complex Regional Pain Syndrome: A Systematic Review.” Anesthesia and analgesia (2016). PMID: 26891396 ↗

    L2SR_OBSCited in: Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Regional and Interventional Procedures
  243. [243]

    Cuenca-Martínez F, Reina-Varona Á, Castillo-García J et al.. “Pain relief by movement representation strategies: An umbrella and mapping review with meta-meta-analysis of motor imagery, action observation and mirror therapy.” European journal of pain (London, England) (2021). PMID: 34592050 ↗

    L1SR_OBSCited in: Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Complications
  244. [244]

    Ringer R, Wertli M, Bachmann LM et al.. “Concordance of qualitative bone scintigraphy results with presence of clinical complex regional pain syndrome 1: meta-analysis of test accuracy studies.” European journal of pain (London, England) (2012). PMID: 22473897 ↗

    L1SR_OBSCited in: Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  245. [245]

    Harvie DS, Stanton TR, Kennedy H et al.. “Visually evoked pain and its extinction using virtual reality in a patient with complex regional pain syndrome type II.” Pain (2022). PMID: 35297803 ↗

    L4CASE_REPORTCited in: Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  246. [246]

    Shafiee E, MacDermid J, Packham T et al.. “A Systematic Critical Appraisal of Clinical Practice Guidelines for Non-Pharmacological ‎Conservative Management of Complex Regional Pain Syndrome (CRPS) Using the ‎AGREE-II Instrument.” Journal of evaluation in clinical practice (2026). PMID: 42080801 ↗

    L2GUIDELINECited in: Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  247. [247]

    Floegel M, Steinmetz S, Dimova V et al.. “Aberrant sensorimotor coupling and movement planning in complex regional pain syndrome.” Pain (2022). PMID: 36251980 ↗

    L3OTHERCited in: Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  248. [248]

    Drummond PD, Finch PM. “Photophobia in complex regional pain syndrome: visual discomfort is greater on the affected than unaffected side.” Pain (2021). PMID: 33086284 ↗

    L3OTHERCited in: Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  249. [249]

    Frare JM, Rodrigues P, Kittel LJ et al.. “Inflammatory biomarkers in complex regional pain syndrome: A systematic review and meta-analysis.” The journal of pain (2026). PMID: 42214577 ↗

    L1SR_OBSCited in: Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  250. [250]

    Ferraro MC, O'Connell NE, Goebel A et al.. “Efficacy and Safety of Bisphosphonates for Complex Regional Pain Syndrome : A Systematic Review and Meta-analysis.” Annals of internal medicine (2025). PMID: 41397259 ↗

    L1SR_OBSCited in: Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  251. [251]

    Blaes F, Dharmalingam B, Tschernatsch M et al.. “Improvement of complex regional pain syndrome after plasmapheresis.” European journal of pain (London, England) (2014). PMID: 25115658 ↗

    L4CASE_REPORTCited in: Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  252. [252]

    Wang L, Guo TZ, Hou S et al.. “Bisphosphonates Inhibit Pain, Bone Loss, and Inflammation in a Rat Tibia Fracture Model of Complex Regional Pain Syndrome.” Anesthesia and analgesia (2016). PMID: 27636578 ↗

    L5OTHERCited in: Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  253. [253]

    Lewis JS, Wallace CS, White P et al.. “Early versus persistent Complex Regional Pain Syndrome: Is there a difference in patient reported outcomes following rehabilitation?” European journal of pain (London, England) (2023). PMID: 37947050 ↗

    L2OTHERCited in: Multimodal Analgesia Ladder and Long-term Pharmacotherapy
  254. [254]

    Llewellyn A, McCabe CS, Hibberd Y et al.. “Are you better? A multi-centre study of patient-defined recovery from Complex Regional Pain Syndrome.” European journal of pain (London, England) (2017). PMID: 29194871 ↗

    L5OTHERCited in: Multimodal Analgesia Ladder and Long-term Pharmacotherapy, Special Populations and Pregnancy
  255. [255]

    Taylor RS, Van Buyten JP, Buchser E. “Spinal cord stimulation for complex regional pain syndrome: a systematic review of the clinical and cost-effectiveness literature and assessment of prognostic factors.” European journal of pain (London, England) (2006). PMID: 16310712 ↗

    L4SR_OBSCited in: Regional and Interventional Procedures, Prognosis and Natural History
  256. [256]

    Eriksen LE, Terkelsen AJ, Blichfeldt-Eckhardt MR et al.. “Spinal cord stimulation in severe cases of complex regional pain syndrome: A retrospective cohort study with long-term follow-up.” European journal of pain (London, England) (2021). PMID: 34196075 ↗

    L2COHORTCited in: Regional and Interventional Procedures, Prognosis and Natural History
  257. [257]

    Farid IS, Heiner EJ. “Intrathecal local anesthetic infusion as a treatment for complex regional pain syndrome in a child.” Anesthesia and analgesia (2007). PMID: 17456655 ↗

    L4CASE_REPORTCited in: Regional and Interventional Procedures, Special Populations and Pregnancy
  258. [258]

    Verdolin MH, Stedje-Larsen ET, Hickey AH. “Ten consecutive cases of complex regional pain syndrome of less than 12 months duration in active duty United States military personnel treated with spinal cord stimulation.” Anesthesia and analgesia (2007). PMID: 17513657 ↗

    L4CASE_REPORTCited in: Regional and Interventional Procedures
  259. [259]

    Mattie R, Lin AB, Bhandal H et al.. “Spinal cord stimulation for the treatment of complex regional pain syndrome: A systematic review of randomized controlled trials.” Interventional pain medicine (2024). PMID: 39717450 ↗

    L1SR_MA_RCTCited in: Regional and Interventional Procedures
  260. [260]

    Thomson S, Huygen F, Prangnell S et al.. “Appropriate referral and selection of patients with chronic pain for spinal cord stimulation: European consensus recommendations and e-health tool.” European journal of pain (London, England) (2020). PMID: 32187774 ↗

    L5OTHERCited in: Regional and Interventional Procedures
  261. [261]

    Blazek F, Krahulik D, Hrabalek L et al.. “Long-term efficacy of neuromodulation in chronic pain management: a single-center retrospective study.” Frontiers in pain research (Lausanne, Switzerland) (2026). PMID: 41704662 ↗

    L2COHORTCited in: Regional and Interventional Procedures
  262. [262]

    Saengsomsuan N, Euasobhon P, Sitthinamsuwan B et al.. “The Long-term Outcome of Usual and Unusual Indications for Spinal Cord Stimulation: A Prospective Study.” Pain physician (2025). PMID: 39903023 ↗

    L2COHORTCited in: Regional and Interventional Procedures, Prognosis and Natural History, Special Populations and Pregnancy
  263. [263]

    Rodas R. “Spinal Cord Stimulation Using High Frequency Electromagnetic Coupling (HF-EMC) Technology to Power an Implanted Neurostimulator With a Separate Receiver for Treating Chronic Back and Leg Pain: A Retrospective Study.” Pain physician (2025). PMID: 39903021 ↗

    L2COHORTCited in: Regional and Interventional Procedures
  264. [264]

    Song IA, Lee JH, Han WK et al.. “The actual duration of spinal cord stimulator use in patients with complex regional pain syndrome: a Korean nationwide cohort study.” The Korean journal of pain (2024). PMID: 39711251 ↗

    L2COHORTCited in: Regional and Interventional Procedures
  265. [265]

    Ahmad A, Perez-Bravo E. “Stellate ganglion block causing reproducible improvement of allergic rhinitis and asthma: a case report.” Pain reports (2026). PMID: 41958858 ↗

    L4CASE_REPORTCited in: Regional and Interventional Procedures
  266. [266]

    Sterling L, Fisher K, Woodbury A. “Stellate Ganglion Block for PTSD and Chronic Low Back Pain: A Case Report of Three Veterans.” Journal of clinical medicine (2025). PMID: 40429371 ↗

    L4CASE_REPORTCited in: Regional and Interventional Procedures
  267. [267]

    Robinson CL, Hunter C, Orhurhu V et al.. “Retrograde cervical insertion of spinal cord stimulator in persistent spinal pain syndrome type 2 in patient with fusion from sacrum to T10.” Pain practice : the official journal of World Institute of Pain (2025). PMID: 40022507 ↗

    L4CASE_REPORTCited in: Regional and Interventional Procedures
  268. [268]

    Gupta P, Sastri V, Sharobim A et al.. “Invasive Spinal Neuromodulation for Chronic Pain in Pediatric Patients: A Scoping Review.” Pain practice : the official journal of World Institute of Pain (2026). PMID: 42351321 ↗

    L5REVIEW_NARRATIVECited in: Regional and Interventional Procedures
  269. [269]

    Borsook D, Rosenthal P. “Chronic (neuropathic) corneal pain and blepharospasm: five case reports.” Pain (2011). PMID: 21752546 ↗

    L4CASE_REPORTCited in: Complications
  270. [270]

    Wijaya LK, Morici MV, Stumbles PA et al.. “Stimulation of alpha-1 adrenoceptors may intensify cutaneous inflammation in complex regional pain syndrome.” Pain (2022). PMID: 35994594 ↗

    L5OTHERCited in: Complications
  271. [271]

    Gilanyi YL, Ferraro MC, Goebel A et al.. “Amputation for complex regional pain syndrome: A systematic review.” The journal of pain (2025). PMID: 41047056 ↗

    L4SR_OBSCited in: Complications, Prognosis and Natural History
  272. [272]

    Frappa N, Dillon MR, Papalia AG et al.. “Age-Stratified Sequelae After Nonoperative Distal Radius Fractures: A Propensity-Matched Cohort Study.” Hand (New York, N.Y.) (2026). PMID: 42283105 ↗

    L2COHORTCited in: Complications
  273. [273]

    Shekouhi R, Singh Y, Byrd B et al.. “Comparative outcomes of single versus multiple trigger finger releases: a propensity score matched cohort study.” The Journal of hand surgery, European volume (2026). PMID: 42108640 ↗

    L2COHORTCited in: Complications
  274. [274]

    de Jong JR, Vlaeyen JWS, van Eijsden M et al.. “Reduction of pain-related fear and increased function and participation in work-related upper extremity pain (WRUEP): effects of exposure in vivo.” Pain (2012). PMID: 22902198 ↗

    L2RCTCited in: Prognosis and Natural History
  275. [275]

    Rauck RL, North J, Eisenach JC. “Intrathecal clonidine and adenosine: effects on pain and sensory processing in patients with chronic regional pain syndrome.” Pain (2015). PMID: 25599305 ↗

    L1RCTCited in: Prognosis and Natural History
  276. [276]

    Rocha Rde O, Teixeira MJ, Yeng LT et al.. “Thoracic sympathetic block for the treatment of complex regional pain syndrome type I: a double-blind randomized controlled study.” Pain (2014). PMID: 25149143 ↗

    L1RCTCited in: Prognosis and Natural History
  277. [277]

    den Hollander M, Goossens M, de Jong J et al.. “Expose or protect? A randomized controlled trial of exposure in vivo vs pain-contingent treatment as usual in patients with complex regional pain syndrome type 1.” Pain (2016). PMID: 27429174 ↗

    L1RCTCited in: Prognosis and Natural History
  278. [278]

    Daly AE, Bialocerkowski AE. “Does evidence support physiotherapy management of adult Complex Regional Pain Syndrome Type One? A systematic review.” European journal of pain (London, England) (2008). PMID: 18619873 ↗

    L2SR_OBSCited in: Prognosis and Natural History
  279. [279]

    Watson CPN. “Do nerve resection, amputation, and immunotherapy relieve causalgia in the long term?” Pain (2025). PMID: 40788267 ↗

    L4CASE_REPORTCited in: Prognosis and Natural History
  280. [280]

    Brunner F, Bachmann LM, Perez RSGM et al.. “Painful swelling after a noxious event and the development of complex regional pain syndrome 1: A one-year prospective study.” European journal of pain (London, England) (2017). PMID: 28573699 ↗

    L2COHORTCited in: Special Populations and Pregnancy
  281. [281]

    Schilder JCM, Schouten AC, Perez RSGM et al.. “Motor control in complex regional pain syndrome: a kinematic analysis.” Pain (2012). PMID: 22336720 ↗

    L3OTHERCited in: Special Populations and Pregnancy
  282. [282]

    Finniss DG, Murphy PM, Brooker C et al.. “Complex regional pain syndrome in children and adolescents.” European journal of pain (London, England) (2006). PMID: 16439174 ↗

    L4CASE_REPORTCited in: Special Populations and Pregnancy
  283. [283]

    de Rooij AM, de Mos M, Sturkenboom MC et al.. “Familial occurrence of complex regional pain syndrome.” European journal of pain (London, England) (2008). PMID: 18514555 ↗

    L3CASE_REPORTCited in: Special Populations and Pregnancy
  284. [284]

    Richards S, Chalkiadis G, Lakshman R et al.. “Complex regional pain syndrome following immunisation.” Archives of disease in childhood (2012). PMID: 22858647 ↗

    L4CASE_REPORTCited in: Prevention, Screening and Surveillance
  285. [285]

    Cho JH, Ahn HC, Choi Y. “Post-COVID-19 vaccination arm pain diagnosed as complex regional pain syndrome: A case report.” Pain practice : the official journal of World Institute of Pain (2022). PMID: 36310420 ↗

    L4CASE_REPORTCited in: Prevention, Screening and Surveillance
  286. [286]

    Hviid A, Thorsen NM, Valentiner-Branth P et al.. “Association between quadrivalent human papillomavirus vaccination and selected syndromes with autonomic dysfunction in Danish females: population based, self-controlled, case series analysis.” BMJ (Clinical research ed.) (2020). PMID: 32878745 ↗

    L2CASE_REPORTCited in: Prevention, Screening and Surveillance
  287. [287]

    Swanson JW, Watt AJ, Vedder NB. “Skin graft loss resulting from collagenase clostridium histolyticum treatment of Dupuytren contracture: case report and review of the literature.” The Journal of hand surgery (2013). PMID: 23391354 ↗

    L4CASE_REPORTCited in: Prevention, Screening and Surveillance
  288. [288]

    Reuben SS. “Chronic pain after surgery: what can we do to prevent it.” Current pain and headache reports (2007). PMID: 17214915 ↗

    L5REVIEW_NARRATIVECited in: Prevention, Screening and Surveillance
  289. [289]

    Barboi A, Gibbons CH, Axelrod F et al.. “Human papillomavirus (HPV) vaccine and autonomic disorders: a position statement from the American Autonomic Society.” Clinical autonomic research : official journal of the Clinical Autonomic Research Society (2019). PMID: 31475305 ↗

    L1REVIEW_NARRATIVECited in: Prevention, Screening and Surveillance

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