The Natural History of Complex Regional Pain Syndrome
Abstract
OBJECTIVE: Complex regional pain syndrome (CRPS) is a severe chronic pain condition characterized by sensory, autonomic, motor, and dystrophic signs and symptoms. This study was undertaken to expand our current knowledge of the evolution of CRPS signs and symptoms with duration of disease. METHOD: This was a retrospective, cross-sectional analysis using data extracted from a patient questionnaire to evaluate the clinical characteristics of CRPS at different time points of disease progression. Data from the questionnaire included pain characteristics and associated symptoms. It also included autonomic, motor, and dystrophic symptoms and also initiating events, ameliorating and aggravating factors, quality of life, work status, comorbid conditions, pattern of pain spread, family history, and demographics. Comparisons were made of different parameters as they varied with disease duration. RESULTS: A total of 656 patients with CRPS of at least 1-year duration were evaluated. The average age of all participants was 37.5 years, with disease duration varying from 1 to 46 years. The majority of participants were white (96%). A total of 80.3% were females. None of the patients in this study demonstrated spontaneous remission of their symptoms. The pain in these patients was refractory showing only modest improvement with most current therapies. DISCUSSION: This study shows that although CRPS is a progressive disease, after 1 year, the majority of the signs and symptoms were well developed and although many variables worsen over the course of the illness, the majority demonstrated only moderate increases with disease duration.
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Many people have persistent CRPS with severe functional impairment and decreased quality of life.
“many people have persistent CRPS with severe functional impairment and decreased quality of life [3, 4].”
From Symptom reduction and improved function in chronic CRPS type 1 after 12-week integrated, interdisciplinary therapy (2019) · cites this paper as [4]
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Self-citationIncreased efficacy of early spinal cord stimulation in an animal model of neuropathic pain
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Intramuscular botulinum toxin in complex regional pain syndrome: case series and literature review.
Kharkar, S., Ambady, P., Venkatesh, Y. S., & Schwartzman, R. J. (2011) · PubMed · Cited by 40 · see citing works
Self-citationThe Role of the Peripheral Nerve Surgeon in the Treatment of Pain
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Migraine may be a risk factor for the development of complex regional pain syndrome
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miR-34a-mediated regulation of XIST in female cells under inflammation
Shenoda, B. B., Tian, Y., Alexander, G. M., Aradillas, E., Schwartzman, R. J., & Ajit, S. K. (2018) · Journal of Pain Research · doi:10.2147/jpr.s159458 · Cited by 34 · see citing works
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Intramuscular Botulinum Toxin in Complex Regional Pain Syndrome: Case Series and Literature Review
Schwartzman, R. J. (2011) · Pain Physician · doi:10.36076/ppj.2011/14/419 · Cited by 31 · see citing works
Self-citationSpinal Cord Stimulation in Complex Regional Pain Syndrome Type I of Less Than 12-Month Duration
van Eijs, F., Geurts, J. W., Zundert, J. H. M. V., Faber, C. G., Kessels, A. G. H., Joosten, E. A. J., & van Kleef, M. (2012) · Neuromodulation Technology at the Neural Interface · doi:10.1111/j.1525-1403.2011.00424.x · Cited by 29 · see citing works
Skin Biopsy in Complex Regional Pain Syndrome: Case Series and Literature Review
Schwartzman, R. J. (2012) · Pain Physician · doi:10.36076/ppj.2012/15/255 · Cited by 27 · see citing works
Self-citationFour Treatment Strategies for Complex Regional Pain Syndrome Type 1
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Establishing a relationship between bacteria in the human gut and Complex Regional Pain Syndrome
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Roles of Long Non-coding RNAs in the Development of Chronic Pain
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Complex regional pain syndrome following trigeminal nerve injury: report of 2 cases
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The Parturient With Implanted Spinal Cord Stimulator
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Fibromyalgia as a Predictor of Complex Regional Pain Syndrome After Distal Radius Fracture
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The Evolving Role of High‐Frequency Spinal Cord Stimulation as Salvage Therapy in Neurostimulation
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Complex regional pain syndrome: an evolving perspective
Cutts, S., Gangoo, S., Srinivasan, S. H., Modi, N., Pasapula, C., & Power, D. (2020) · Postgraduate Medical Journal · doi:10.1136/postgradmedj-2020-137808 · Cited by 22 · see citing works
Subliminal (latent) processing of pain and its evolution to conscious awareness
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Intramuscular Botulinum Toxin A (BtxA) in Complex Regional Pain Syndrome
Schwartzman, R. J. (2011) · Pain Physician · doi:10.36076/ppj.2011/14/311 · Cited by 20 · see citing works
Self-citationCRPS-Related Neurogenic Edema Responsive to Dextromethorphan/Quinidine
Ferrara, J. M. (2014) · Pain Medicine · doi:10.1111/pme.12539 · Cited by 19 · see citing works
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Reliability of Infrared Thermometric Measurements of Skin Temperature in the Hand
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Long-term Outcomes Using Intrathecal Drug Delivery Systems in Complex Regional Pain Syndrome
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Widespread Pain in Patients with Complex Regional Pain Syndrome
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Identification and Treatment of New Inflammatory Triggers for Complex Regional Pain Syndrome
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Systemic Complications of Complex Regional Pain Syndrome
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Self-citationFibromyalgia and the complex regional pain syndrome: similarities in pathophysiology and treatment
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Current Analysis of Women Athletes with Pelvic Pain
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Thermal Pain in Complex Regional Pain Syndrome Type I
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Gardner-Diamond syndrome associated with complex regional pain syndrome
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Self-citationWork Prognosis of Complex Regional Pain Syndrome Type I
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Komplexes regionales Schmerzsyndrom
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Complex Regional Pain Syndrome
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Comparison of complex regional pain syndrome and fibromyalgia
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Ketamine for Complex Regional Pain Syndrome
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Syncope in Complex Regional Pain Syndrome
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Diagnosis and Treatment of Complex Regional Pain Syndrome
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Clinical indications for spinal cord stimulation
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- Authors
- Schwartzman, R. J., Erwin, K. L., & Alexander, G. M.
- Affiliations
- Drexel University (US)
- Venue
- The Clinical Journal of Pain
- Published
- 2009-05
- Volume
- 25
- Issue
- 4
- Pages
- 273-280
- ISSN
- 0749-8047 (ISSN-L)
- OpenAlex
- W2011352969
- Cited by
- 191
- References
- 61
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 8 · 2023: 12 · 2022: 7 · 2021: 13 · 2020: 9 · 2019: 10 · 2018: 10 · 2017: 12 · 2016: 12 · 2015: 9 · 2014: 16 · 2013: 15 · 2012: 20
- FWCI
- 19.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
- Keywords
- complex regional pain syndrome, disease progression, disease duration, chronic pain, autonomic symptoms, motor symptoms, refractory pain, quality of life, employment status, comorbidities, pain spread, family history (medicine)
- MeSH terms
- Adult, Female, Humans, Male, Pain Measurement, Pennsylvania, Cohort Studies, Prevalence, Disease Progression, Complex Regional Pain Syndromes
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