From the Guidelines
The incidence of Complex Regional Pain Syndrome (CRPS) is not well-established due to limited data, but it is reported to occur in patients living with HIV (PLWH) and is generally considered a rare condition. The condition is characterized by excruciating pain, often made worse by touch or stimulation, and can be associated with hair loss, tissue changes, and skin discoloration at the site of the pain 1. Some studies suggest that CRPS can occur after an injury, often minor, and sympathetic dysregulation is proposed to play a role in its development 1. Key characteristics of CRPS include:
- Excruciating pain that gradually increases in intensity and size in the affected limb
- Association with hair loss, tissue changes, and skin discoloration at the site of the pain
- Proposed role of sympathetic dysregulation in its development
- Reported occurrence in patients living with HIV (PLWH) Given the limited data available on the incidence of CRPS, it is essential to prioritize early recognition and intervention to improve outcomes, as the condition is relatively rare and contributes to diagnostic challenges and delays in treatment. Further research is needed to establish a clear understanding of the incidence of CRPS, but current evidence suggests that it is a rare and complex condition that requires prompt attention and management 1.
From the Research
Incidence of Complex Regional Pain Syndrome (CRPS)
- The estimated overall incidence rate of CRPS is 26.2 per 100,000 person years (95% CI: 23.0-29.7) 2.
- Females are affected at least three times more often than males (ratio: 3.4) 2.
- The highest incidence occurs in females in the age category of 61-70 years 2.
- The incidence of CRPS after surgery is 0.34% 3.
- Women are more frequently affected, and most patients are between 50 and 70 years old 3.
- The incidence of CRPS is around 5-26/100 000 4.
- CRPS occurs in 5% of cases after injury or surgery, particularly in the limbs 4.
- It occurs acutely in about 7% of patients who have limb fractures, limb surgery, or other injuries 5.
Risk Factors and Demographics
- Postmenopausal women appear to be at the highest risk for the development of CRPS 2.
- A fracture is the most common precipitating event (44%) 2.
- The upper extremity is affected more frequently than the lower extremity 2.
- The incidence of CRPS after surgeries of the upper limb is 3 times higher than after lower-limb surgeries (0.60% vs 0.20%) 3.
Treatment and Management
- Physiotherapy and occupational therapy are commonly used treatments for CRPS 3, 4, 5.
- Nonopioid pain medication is also frequently used 3.
- Opioids and/or antineuropathic medication are used in approximately 40% to 50% of patients 3.
- Cortisone, bisphosphonates, pain therapy, and occupational therapy are rarely claimed 3.