The Management of Complex Regional Pain Syndrome (crps)

The first step in the management of complex regional pain syndrome (CRPS) is coming to the arrival at an accurate diagnosis. CRPS is diagnosed by inclusion and not by exclusion. No laboratory tests can diagnose CRPS 100% of the time. The use of scintigraphic triphasic bone scans (STBS) may help diagnose CRPS in approximately 55% of the cases in the first six months(1). The research of Chelimsky et al., found STBS to be abnormal in no more than 25% of CRPS patients(2). The use of infrared thermal imaging (ITI) is useful in the diagnosis and management of CRPS pain. It provides an overall picture of temperature changes in superficial and deep structures (27 mm) (3-5). ITI provides useful clinical information when applied with proper technique. It provides diagnostic and therapeutic information limited to diseases involving autonomic, neurovascular, and neuroinflammatory changes(3,6,7). CRPS is a clinical diagnosis corroborated by test such as laser doppler, STBS, and ITI. Early diagnosis is essential for successful treatment of CRPS(8-10). Descriptors. complex regional pain syndrome (CRPS), epidural nerve block, early diagnosis, infrared thermal imaging (ITI), scintigraphic triphasic bone scans (STBS), sympathetic ganglion block (SGB)