Early Recognition and Management of Complex Regional Pain Syndrome Following Distal Radius Fracture: A Structured Narrative Review
Abstract
Complex regional pain syndrome (CRPS) is a chronic pain disorder that may develop following a distal radius fracture and can result in significant functional impairment and prolonged disability. Early diagnosis remains challenging because symptoms frequently overlap with normal post-fracture recovery. This structured narrative review evaluated current evidence regarding the timing of diagnosis, early predictors, and early management strategies influencing outcomes of CRPS following distal radius fracture. A structured literature search of PubMed/MEDLINE and Embase was performed for English-language studies published between 2000 and 2026 using combinations of keywords related to CRPS, distal radius fracture, diagnosis, risk factors, prevention, and management. Studies involving adult patients with CRPS following distal radius or wrist fracture and addressing diagnosis, predictors, or early management strategies were included. Owing to heterogeneity in study designs and outcome measures, findings were synthesized using thematic narrative analysis. Twenty-six studies met the inclusion criteria. Evidence suggests that clinical and physiological abnormalities associated with CRPS may emerge during the early post-injury period, although formal diagnosis is often established weeks to months after fracture treatment. Higher early pain intensity, enhanced pain sensitization, fibromyalgia, female sex, older age, lower vitamin D levels, and certain genetic polymorphisms were…
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