Primary prevention of Complex Regional Pain Syndrome: A narrative review

Abstract

Complex regional pain syndrome (CRPS) is a post-traumatic pain syndrome. The pathophysiology is still partially unknown, making treatment difficult for all care providers. The lack of reliable treatment highlights the need for prevention. Several studies and review articles already showed a positive effect of vitamin C on the incidence of CRPS. This narrative review aims to go beyond the effects of vitamin C and review all the literature discussing possible (non-)pharmacological options to prevent the onset of this disease. This narrative review includes 24 articles reviewing 9 drugs and a few other non-pharmacological options such as garroting, length of surgery and surgical approach. The results confirm the known effects of vitamin C on the incidence of CRPS. Pre-clinical research points towards drugs like ketamine, dexmedetomidine, omega-3 fatty acids and elcalcitonin to possibly prevent CRPS in the future. Larger humane studies are needed to prove the preventive power of these drugs. The need for a multidisciplinary approach is shown by the possible effect of minimally invasive surgery, short garroting time and early mobilization by a home-exercise program.