Medication in the Management of Complex Regional Pain Syndrome ( CRPS )

Complex regional pain syndrome (CRPS) is a syndrome defined as a state of constant burning and pain which is severe, incapacitating, and is aggravated by even a breeze or a simple touch to the involved area (allodynia). In our review of 824 CRPS patients, the pain of CRPS is accompanied by swelling, inflammation, disturbance of the immune system function, movement disorder (flexion spasm, tremor, etc.) and emotional disturbance in the form of insomnia, depression, agitation, and irritability (1,2). In CRPS, the chronic pain is not because of the abuse of drugs, the chronic pain is because of a delay in diagnosis and a delay in treatment. The other factor that causes the chronic pain in CRPS is inflammation which is part and parcel of CRPS. Anti-inflammatory medications such as mobic (meloxicam), voltaren (diclofenac) (gel or tablet), celebrex (celecoxib) are also helpful in the treatment of CRPS. With the help of the combination of the proper antidepressants (e.g., desyrel (trazodone), Zoloft (sertraline), paxil (paroxetine), and prozac (fluoxetine) as well as the use of strong non-addicting pain medications the patient will become pain free which is the key to the treatment of CRPS. The symptoms of CRPS cannot be brought under control unless the pain is brought under control. In this article, we will discuss which medications are helpful in the management of CRPS.