Abstract
The purpose of this systematic review was to examine the outcome of complex regional
pain syndrome (CRPS) type 1. We searched MEDLINE, Embase, and PsycINFO for relevant
studies and included 18 studies, with 3,991 participants, in this review. The following
data were extracted: study details, measurement tools used, and rates or severity
scores for the symptoms/signs of CRPS at baseline and follow-up, or in groups of patients
with different disease durations. A quality assessment revealed significant limitations
in the literature, with many studies using different diagnostic criteria. The 3 prospective
studies demonstrated that for many patients, symptoms improve markedly within 6 to
13 months of onset. The 12 retrospective studies had highly heterogeneous findings,
documenting lasting impairments in many patients. The 3 cross-sectional studies showed
that rates of pain and sensory symptoms were highest among those with the longest
duration of CRPS. Additionally, most studies showed that motor symptoms (stiffness
and weakness) were the most likely to persist whereas sudomotor and vasomotor symptoms
were the most likely to improve. Overall, this suggests that some CRPS patients make
a good early recovery whereas others develop lasting pain and disability. As yet little
is known about the prognostic factors that might differentiate between these groups.
Perspective
We found evidence that many CRPS patients recover within 6 to 13 months, but a significant
number experience some lasting symptoms, and some experience chronic pain and disability.
The quality of the evidence was poor. Future research should examine the factors associated
with recovery and identify those at risk of poor outcomes.
Key words
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Article info
Publication history
Published online: February 13, 2014
Footnotes
No funding was received for this systematic review but we wish to thank the Oakley Mental Health Research Foundation for support with our CRPS research in general.
All authors wish to declare that they have no conflict of interest.
Supplementary data accompanying this article are available online at www.jpain.org and www.sciencedirect.com.
Identification
Copyright
© 2014 American Pain Society. Published by Elsevier Inc. All rights reserved.
