title: Complex regional pain syndrome type I: a comprehensive review.
abstract: BACKGROUND
  Complex regional pain syndrome type I (CRPS I), formerly known as reflex sympathetic dystrophy (RSD), is a chronic painful disorder that usually develops after a minor injury to a limb. This topical review gives a synopsis of CRPS I and discusses the current concepts of our understanding of CRPS I in adults, the diagnosis, and treatment options based on the limited evidence found in medical literature. CRPS I is a multifactorial disorder. Possible pathophysiological mechanisms of CRPS I are classic and neurogenic inflammation, and maladaptive neuroplasticity. At the level of the central nervous system, it has been suggested that an increased input from peripheral nociceptors alters the central processing mechanisms.
  
  
  METHODS
  A literature search was conducted using, as electronic bibliographic database, Medline from 1980 until 2014.
  
  
  RESULTS
  An early diagnosis and multidisciplinary treatment are necessary to prevent permanent disability.
  
  
  CONCLUSIONS
  The pharmacological treatment of CRPS I is empirical and insufficiently effective. Further research is needed regarding the therapeutic modalities discussed in the guidelines. Physical therapy is widely recommended as a first-line treatment. The efficacy of local anesthetic sympathetic blockade as treatment for CRPS I is questionable.
authors.affiliation: O.U. of Anesthesia, Intensive Care and Pain Therapy of Sant'Antonio Abate Hospital, Casa Santa Erice, Trapani, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bussa
authors.affiliation: O.U. of Anesthesia, Intensive Care and Pain Therapy of Sant'Antonio Abate Hospital, Casa Santa Erice, Trapani, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Guttilla
authors.affiliation: O.U. of Anesthesia, Intensive Care and Pain Therapy of Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, Palermo, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Lucia
authors.affiliation: Anaesthesiology, Intensive Care and Pain Therapy Department, Catholic University, Medical School, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Mascaro
authors.affiliation: Plastic and Reconstructive Surgery Department, University 'Sapienza' of Rome, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Rinaldi
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D006801:Humans; D012019:Reflex Sympathetic Dystrophy / Q000175:diagnosis* / Q000628:therapy*