The Analgesic Efficacy of Therapies Used for Complex Regional Pain Syndrome: A Systematic Review
Abstract
Complex regional pain syndrome (CRPS) is a debilitating chronic pain condition that may develop after fractures, surgery, or soft tissue trauma. It is characterized by pain disproportionate to the initial injury, often accompanied by sensory, motor, autonomic, and trophic changes. Despite extensive research, pathophysiology remains unclear, and treatment approaches are varied, with inconsistent supporting evidence. Given its complexity and the potential for chronic disability, identifying effective therapies remains a clinical priority. This review systematically evaluated the analgesic efficacy of pharmacological and non-pharmacological therapies for CRPS, based on randomized controlled trials (RCTs) published between 2003 and 2025. The protocol was developed previously and registered in PROSPERO (CRD420251026503). A structured literature search using a PICO (Population, Intervention, Comparator, Outcome) framework was conducted across MEDLINE, PubMed, and the Cochrane Library. Search terms included "Complex Regional Pain Syndrome," its earlier term "Reflex Sympathetic Dystrophy," and intervention-specific keywords. Included were English-language RCTs in adults with clinically diagnosed CRPS (type I or II), assessing pain reduction as the primary outcome and function, quality of life, and pain medication use as secondary outcomes. Two reviewers independently screened and extracted studies. Risk of bias was assessed using the Cochrane Risk of Bias (ROB) 2. Publication bias…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 2,125 participants or records.
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