From the Guidelines
Causalgia, also known as Complex Regional Pain Syndrome (CRPS), is a clinical form of pain characterized by cut nerves and prolonged pain, often seen in soldiers during wartime. This condition is described as excruciating and made worse by touch or stimulation, with pain gradually increasing in intensity and size in the affected limb, sometimes spreading to the contralateral limb 1. The exact prevalence of CRPS is unknown, but it has been reported in various populations, including those living with HIV 1.
Key Characteristics of CRPS
- Excruiciating pain made worse by touch or stimulation
- Pain gradually increases in intensity and size in the affected limb
- May spread to the contralateral limb
- Associated with hair loss, tissue changes, and skin discoloration at the site of the pain
- Sympathetic dysregulation is proposed to play a role in the development of CRPS 1
Treatment and Management
Treatment of CRPS typically involves a multimodal approach, but the exact treatment protocol is not specified in the provided evidence. However, it is essential to note that CRPS does not have noticeable placebo analgesia except at very early time points, highlighting the need for effective treatment strategies 1.
Pathophysiology
The exact pathophysiology of CRPS is not fully understood, but it is proposed that sympathetic dysregulation plays a role in the development of this condition 1. Further research is needed to understand the underlying mechanisms of CRPS and to develop effective treatment strategies.
From the Research
Clinical Form of Pain
- Causalgia is a clinical form of pain characterized by cut nerves and prolonged pain, often seen in soldiers during wartime 2, 3, 4.
- This condition is also known as Complex Regional Pain Syndrome (CRPS) type II, which is associated with nerve damage 2, 3, 4, 5.
- CRPS type II is characterized by severe, disproportionate pain, often accompanied by hyperalgesia, allodynia, trophic changes, and motor impairments 2, 3, 4.
Characteristics of CRPS
- CRPS is a chronic pain condition that can occur after trauma or nerve injury 2, 3, 4, 5, 6.
- The condition is classified into two types: CRPS type I (without nerve injury) and CRPS type II (associated with nerve damage) 2, 3, 4, 5.
- CRPS exhibits a complex pathophysiology involving peripheral and central sensitization, neurogenic inflammation, maladaptive brain plasticity, and potential autoimmune and psychological influences 2, 3, 4, 6.
Diagnosis and Treatment
- The diagnosis of CRPS relies primarily on clinical evaluation using criteria such as the Budapest Criteria, supported by supplementary tests to exclude differential diagnoses 2, 3, 4, 5, 6.
- The management of CRPS necessitates a multidisciplinary approach combining physical therapy, psychological support, and pharmacotherapy 2, 3, 4, 5, 6.
- Treatment options include rehabilitation therapies, neuropathic pain medications, and electric stimulation of the spinal cord, injured nerve, or motor cortex 2, 3, 4, 5, 6.