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जटिल क्षेत्रीय दर्द सिंड्रोम (सीआरपीएस)

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What CRPS is, why it sometimes follows a wrist or hand injury or operation, how it is recognised and treated, and what recovery looks like.

Updated Sep 2026
एक नरम प्रभामंडल वाला हाथ जो उच्च संवेदनशीलता का सुझाव देता है।
सीआरपीएस में एक अंग तीव्र रूप से दर्दनाक, सूजन और मूल चोट के अनुपात से अधिक संवेदनशील हो सकता है। Kieran Hirpara 4.0

यह पृष्ठ मशीन द्वारा अनूदित है और अभी तक किसी चिकित्सक द्वारा जाँचा नहीं गया है। अंग्रेज़ी संस्करण ही आधिकारिक है।

आप क्या महसूस कर रहे हैं

जटिल क्षेत्रीय दर्द सिंड्रोम (सीआरपीएस) एक ऐसी स्थिति है जहां चोट या सर्जरी के बाद दर्द और अन्य लक्षण जारी रहते हैं, अक्सर उन तरीकों से जो मूल समस्या के अनुपात में नहीं लगते हैं। यह आपके हाथ या हाथ को फ्रैक्चर या ऑपरेशन के बाद प्रभावित कर सकता है, और यह एक चीज के बजाय कई कारणों से आता है।

इसका मुख्य लक्षण दर्द है। यह गंभीर और सुखाने वाला हो सकता है, और यह उस स्थान से परे फैल सकता है जहां आपको चोट लगी थी। दर्द अक्सर रात में या अपने हाथ का उपयोग करने के बाद भड़कता है, और जब आप जागते हैं तो यह वहां हो सकता है। इसे उत्तेजित करने वाली चीजों में आंदोलन, स्पर्श, या दर्द वाले क्षेत्र पर दबाव शामिल हैं। हाथ को आराम देने से यह थोड़ा शांत हो सकता है, लेकिन दर्द अभी भी रह सकता है।

रोजमर्रा के कार्य कठिन हो सकते हैं। आप एक केतली को पकड़ने, एक कुंजी को मोड़ने, बटन करने, या एक कलम पकड़ने के लिए संघर्ष कर सकते हैं। लिखना, खाना बनाना, और खरीदारी करना सभी को उतना ही कठिन लग सकता है जितना उन्हें होना चाहिए। कुछ लोगों को लगता है कि वे हाथ का उपयोग करने से बचते हैं क्योंकि वे दर्द से डरते हैं।

सीआरपीएस का निदान आपके इतिहास और एक शारीरिक परीक्षा से किया जाता है, न कि एक स्कैन या रक्त परीक्षण से। आपके डॉक्टर सीआरपीएस को स्पष्टीकरण के रूप में तय करने से पहले निरंतर दर्द के अन्य कारणों की भी जांच करेंगे।

इसे पहचाना जा रहा है और प्रारंभिक मामलों का इलाज किया जा रहा है। शीघ्र उपचार आंदोलन और कार्य की स्थायी हानि की संभावना को कम करता है। फिर भी, कुछ लोगों को अच्छी प्रारंभिक देखभाल के बावजूद कुछ स्थायी हानि या विकलांगता के साथ छोड़ दिया जाता है।

कुछ लोगों को दूसरों की तुलना में सीआरपीएस विकसित होने की अधिक संभावना होती है। कलाई की फ्रैक्चर सर्जरी के बाद महिलाओं, बुजुर्गों और भारी शारीरिक श्रम करने वालों को अधिक जोखिम का सामना करना पड़ता है। मौजूदा तंत्रिका समस्याएं, जैसे कि एक फंसी तंत्रिका या गर्दन तंत्रिका समस्या, जोखिम को और बढ़ा देती है। दुप्योत्रेन संकुचन के लिए सर्जरी के बाद, महिलाओं और एक से अधिक उंगली वाले लोगों को इसे विकसित करने की अधिक संभावना होती है।

यदि आपका दर्द असामान्य लगता है या जैसा आप उम्मीद करते हैं वैसा नहीं होता है, तो अपने डॉक्टर को समय से बताएं।

वास्तव में क्या हो रहा है

सीआरपीएस एक क्षति नहीं है जिसे आप स्कैन पर देख सकते हैं। आपकी हड्डी या ऊतक की चोट ठीक हो सकती है, फिर भी आपका शरीर जिस तरह से दर्द को संसाधित करता है वह बदल गया है। तंत्रिकाएं और मस्तिष्क पहले की तुलना में दर्द के संकेतों को अलग तरीके से भेजते और पढ़ते हैं, इसलिए एक हाथ जो बाहर से ठीक दिखता है वह जलता, कोमल या दर्दनाक महसूस कर सकता है।

इसे एक धुएं के अलार्म की तरह सोचें जो बहुत संवेदनशील हो गया है। धुएं की एक छोटी सी झपकी पूरे अलार्म को चालू कर देती है, और उसी तरह, हल्का स्पर्श या कोमल आंदोलन मजबूत दर्द को चालू कर सकता है। यही कारण है कि आप ऊपर जिन लक्षणों के बारे में पढ़ते हैं, वे स्वयं स्थिति के कारण होते हैं, न कि आपके किसी गलत काम के कारण।

क्योंकि दर्द के संकेत बदल गए हैं, सीआरपीएस का पता लगाने के लिए स्कैन और रक्त परीक्षण विश्वसनीय नहीं हैं। ऐसा कोई भी परीक्षण नहीं है जो इसकी पुष्टि करे। इसके बजाय, आपका डॉक्टर आपके इतिहास और परीक्षा के माध्यम से काम करता है, और पहले अन्य कारणों को बाहर करता है। सीआरपीएस का निदान तभी किया जाता है जब अन्य स्पष्टीकरणों को बाहर रखा गया हो, यही कारण है कि आपको ग्लूमस ट्यूमर जैसी चीजों के लिए जाँच की जा सकती है, नाखून के नीचे छोटी रक्त वाहिकाओं में एक छोटी वृद्धि जो असामान्य चल रहे दर्द का कारण बन सकती है।

यह स्थिति जटिल है, और इसके सटीक कारणों का अध्ययन अभी भी किया जा रहा है। जो ज्ञात है वह यह है कि कई चीजें इसे ट्रिगर करने के लिए मिलकर आ सकती हैं। मौजूदा तंत्रिका समस्याएं, जैसे एक फंसी तंत्रिका या गर्दन तंत्रिका समस्या, कलाई फ्रैक्चर सर्जरी के बाद सबसे मजबूत भविष्यवाणियां हैं। एक फ्रैक्चर से पहले भावनात्मक तनाव का इलाज किया जाता है, जैसे कि चिंता या अवसाद, उपचार के दौरान सीआरपीएस विकसित होने की संभावना लगभग दोगुनी हो जाती है। महिलाओं, बुजुर्गों और भारी शारीरिक श्रम करने वालों को भी अधिक जोखिम का सामना करना पड़ता है।

इसे जल्दी पहचानना महत्वपूर्ण है क्योंकि शीघ्र उपचार से गति की स्थायी हानि की संभावना कम हो जाती है। फिर भी, कुछ लोगों को अच्छी प्रारंभिक देखभाल के बावजूद कुछ स्थायी विकलांगता के साथ छोड़ दिया जाता है।

हम इसके बारे में क्या कर सकते हैं

बहुत कुछ है जो आप स्वयं कर सकते हैं, और यह आमतौर पर आंदोलन से शुरू होता है। हाथ और हाथ को काम करते रखना उपचार का एक केंद्रीय हिस्सा है, और फिजियोथेरेपी का उद्देश्य हाथ का उपयोग करने में गति, शक्ति और आत्मविश्वास का पुनर्निर्माण करना है। चोट लगने वाली चीज़ को हिलाना अजीब लग सकता है, लेकिन कोमल, स्थिर गतिविधि पहले वर्णित अतिसंवेदनशील दर्द संकेतों को शांत करने में मदद करती है। वसूली के लिए अधिक सक्रिय दृष्टिकोण भी चोट के बाद सीआरपीएस के विकास की संभावना को कम करता है। इस दृष्टिकोण को दिनों के बजाय हफ्तों तक निष्पक्ष रूप से चलाएं, और प्रगति धीमी लगने पर भी जारी रखें। कुछ लोगों को दर्पण चिकित्सा भी उपयोगी लगती है, जहां आप दर्पण में देखते हुए अपने अप्रभावित हाथ को हिलाते हैं, और आपका चिकित्सक दर्द को कम करने के लिए लेजर थेरेपी जैसे अन्य उपचारों का उपयोग कर सकता है।

यदि स्वयं प्रबंधन पर्याप्त नहीं है, तो ऐसी दवाएं हैं जो मदद कर सकती हैं। दर्द निवारक और विरोधी भड़काऊ दवाएं फ्लेयर को शांत कर सकती हैं और आंदोलन को अधिक आरामदायक बना सकती हैं, जो महत्वपूर्ण है क्योंकि हाथ को चलाना मुख्य उपचार है। आपका डॉक्टर स्टेरॉयड गोलियों का एक छोटा कोर्स भी सुझा सकता है, जैसे कि प्रेडनिसोलोन, जो सूजन को शांत करता है और लक्षणों को कम कर सकता है, खासकर जब विशेषज्ञ उपचार तक पहुंचना मुश्किल होता है। त्वचा पर सीधे लगाने के विकल्प भी हैं, जैसे कि औषधीय क्रीम, जो दर्द को प्रबंधित करने का एक सरल तरीका प्रदान करते हैं। जिद्दी मामलों में, कुछ लोगों को अस्पताल में केटामाइन इन्फ्यूजन की पेशकश की जाती है, जो दर्द मार्गों पर ही काम करता है। इनमे से प्रत्येक के साइड इफेक्ट्स के बारे में ट्रेड-ऑफ्स होते हैं और लाभ कब तक रहता है, इसलिए यह बात करने के लायक है कि आपके लिए क्या उपयुक्त है।

यदि आपके लक्षण गंभीर हैं और उपरोक्त चरणों के बावजूद अभी भी ठीक नहीं हो रहे हैं, तो एक विशेषज्ञ को देखने के बारे में पूछें। एक डॉक्टर आपको एक विशेषज्ञ मूल्यांकन के लिए भेज सकता है, और कुछ विशिष्ट अंतर्निहित समस्याओं के लिए, कभी-कभी एक प्रक्रिया पर विचार किया जा सकता है। उदाहरण के लिए, जहां कलाई में फंसी एक तंत्रिका लक्षणों को चला रही है, इसे जारी करने से कई लोगों के लिए पूर्ण समाधान हो सकता है, और कठोर जोड़ों को संकुचित किया जा सकता है और फिर धीरे से मुक्त किया जा सकता है। ये निर्णय मामले-दर-मामले पर लिए जाते हैं, जब अन्य कारणों को पहले वर्णित के रूप में खारिज कर दिया जाता है। जितनी जल्दी सीआरपीएस को पहचाना जाए और उसका इलाज किया जाए, उतनी ही बेहतर संभावना है कि आंदोलन की स्थायी हानि से बचा जा सके, इसलिए मदद लेने में देरी न करें।

क्या उम्मीद करें

सीआरपीएस के साथ हर किसी का कोर्स थोड़ा अलग है, और कोई निश्चित समयरेखा नहीं है जिस पर आप भरोसा कर सकते हैं। कुछ लोगों के लिए लक्षण हफ्तों या महीनों में ठीक हो जाते हैं, खासकर जब उपचार जल्दी शुरू किया जाता है। दूसरों के लिए दर्द अधिक समय तक रहता है, और कुछ लोगों को अच्छी प्रारंभिक देखभाल के बाद भी कुछ स्थायी हानि या विकलांगता के साथ छोड़ दिया जाता है। शीघ्र पहचान और शीघ्र उपचार आपको स्थायी गति हानि से बचने का सबसे अच्छा मौका देता है, यही कारण है कि सहायता प्राप्त करने में देरी न करना महत्वपूर्ण है।

यदि इसका अच्छी तरह से प्रबंधन किया जाता है, तो संभावनाएं अक्सर एक अचानक फिक्स के बजाय स्थिर सुधार होती हैं। हाथ को हिलाना, भले ही थोड़ा दर्द हो, पहले वर्णित अतिसंवेदनशील दर्द संकेतों को शांत करने में मदद करता है, और प्रगति आमतौर पर हफ्तों और महीनों में धीरे-धीरे बनती है। कुछ उपचार रास्ते में एक वास्तविक अंतर बना सकते हैं। दर्पण चिकित्सा और लेजर थेरेपी कभी-कभी पहले कुछ सत्रों के भीतर दर्द को कम कर सकती है। जहां कलाई में फंसी एक तंत्रिका लक्षणों को चला रही है, इसे जारी करने से कई लोगों के लिए लक्षणों का पूर्ण समाधान हो सकता है। संकुचित हो चुके कठोर जोड़ों को धीरे-धीरे मुक्त किया जा सकता है और फिर स्प्लिंट किया जा सकता है, जो अच्छी तरह से जाता है।

यदि इसे अकेला छोड़ दिया जाए, तो तस्वीर कम निश्चित है। दर्द भड़कता रह सकता है, और स्थायी जकड़न और कार्यक्षमता के नुकसान की संभावना बढ़ जाती है क्योंकि चीजें लंबे समय तक चलती हैं। गंभीर, लंबे समय तक चलने वाले मामलों में जो किसी अन्य उपचार का जवाब नहीं देते हैं, सर्जरी को कभी-कभी अंतिम उपाय के रूप में माना जाता है। गंभीर चल रहे तंत्रिका दर्द के साथ लोगों की एक छोटी संख्या के लिए, घुटने के नीचे निचले पैर को हटाने से दर्द में सार्थक राहत मिली है और स्वीकार्य कार्य हुआ है। यह एक सामान्य मार्ग नहीं है, और यह केवल तब तौला जाता है जब सब कुछ आज़माया गया हो।

यह कहना सही होगा कि सीआरपीएस अभी भी पूरी तरह से समझ में नहीं आया है और इसके कारणों पर अध्ययन जारी है। जो हम जानते हैं वह यह है कि सक्रिय रहना, जल्दी इलाज करना, और अपनी देखभाल टीम के साथ काम करना आपको सबसे मजबूत आधार देता है। अपनी अपेक्षाओं को धीरे-धीरे प्रगति पर सेट करें, एक त्वरित समाधान नहीं, और रास्ते में अपने डॉक्टर के साथ कुछ भी असामान्य उठाएं।

किसी से कब मिलना है

यदि चोट या सर्जरी के बाद दर्द रात में भड़कता रहता है, घायल स्थान से परे फैलता है, या चोट से कहीं अधिक मजबूत लगता है, तो अपने जीपी या डॉक्टर से जल्दी संपर्क करें। यदि हल्का स्पर्श, कोमल गति, या तापमान परिवर्तन से गंभीर दर्द होता है, या यदि आपका हाथ इतना दर्दनाक हो गया है कि आप इसका उपयोग करने से बचते हैं, तो मदद मांगें। सीआरपीएस को जल्दी पहचानने और उसका इलाज करने से आंदोलन की स्थायी हानि की संभावना कम हो जाती है, इसलिए लक्षणों के अपने आप ठीक होने की प्रतीक्षा न करें। चूंकि सीआरपीएस का निदान तभी किया जाता है जब अन्य कारणों को खारिज कर दिया जाता है, इसलिए मूल चोट के बजाय असामान्य चल रहे दर्द की हमेशा जांच की जानी चाहिए।

Reviewed by Kieran Hirpara · 13 June 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • CRPS is a multifactorial condition that requires further study to better understand its pathogenesis, epidemiology, genetic involvement, psychological implications, and treatment options [3].
  • The diagnosis of CRPS is a clinical diagnosis based on history and physical examination [9].
  • Early recognition and prompt treatment of CRPS are important to minimize permanent loss of function [9].
  • Patients with CRPS may still experience permanent impairment and disability despite early recognition and prompt treatment [9].
  • Quantitative sensory testing outcomes indicate altered pain mechanisms in complex regional pain syndrome compared to controls, with a pooled standardized mean difference of -0.41 [5].
  • The reported incidence of CRPS is influenced by the choice of diagnostic criteria, study location, and how the fracture is managed [15].
  • A more active treatment approach seems to lower the incidence of CRPS-1 following distal radius fracture [2].
  • CRPS following isolated cubital tunnel surgery is exceedingly rare, with an overall 1-year incidence rate of approximately 0.33% [10].
  • The Hamilton Inventory can be relied upon to assess CRPS symptoms, functional limitations, and psychosocial impacts [4].

Background & Causes

Pathophysiology and Diagnosis

  • Quantitative sensory testing outcomes indicate altered pain mechanisms in CRPS compared to controls, with a pooled standardized mean difference of -0.41 [5].
  • Early recognition and prompt treatment are important to minimize permanent loss of function, though patients may still experience permanent impairment and disability [9].

Risk Factors and Incidence

  • Female sex and release of more than one digit are significant predictors of developing CRPS following treatment of Dupuytren contracture [11].
  • Elderly patients, females, and manual laborers have higher risks of developing CRPS after distal radius fracture surgery [13].
  • Preexisting neuropathic disorders, particularly traumatic nerve injuries, compressive neuropathies, and cervical radiculopathy, are the strongest predictors of CRPS after distal radius fracture [17].
  • Patients suffering from scaphoid waist fracture may be at a higher risk of CRPS I, especially in women with diabetes mellitus who report severe pain before treatment [20].
  • CRPS-related hand lesions developed in 19.4% of patients following arthroscopic rotator cuff repair [14].

Modifiable Factors and Management Implications

Symptoms & Presentation

  • CRPS is a multifactorial condition [3].
  • Pain is a highly debilitating symptom in CRPS-I [7].
  • Patients with CRPS may experience permanent impairment and disability [9].
  • Glomus tumors should be included in the differential diagnosis for patients with unusual chronic pain or neuropathy [19].
  • The diagnosis of CRPS should only be a diagnosis of exclusion [19].

Management

Pharmacologic

  • In patients presenting with chronic or refractory CRPS, strong consideration should be given for the use of ketamine [1].
  • Prednisolone is a potential treatment option for CRPS, particularly in resource-limited settings where more specialized interventions may be unavailable [6].
  • Topical application of doxepin may represent a simple option for the management of CRPS [18].

Non-Pharmacologic

  • A more active treatment approach seems to lower the incidence of CRPS-1 [2].
  • High-intensity laser therapy and mirror therapy provide conclusive evidence of pain reduction in CRPS-I, even after the third HILT treatment session [7].
  • The methodological quality of non-pharmacological treatment approaches for upper limb CRPS is overall poor [8].

Operative

  • A large percentage of patients diagnosed with and treated for CRPS type 1 can have full resolution of their symptoms with carpal tunnel release [12].
  • The positive outcome for a patient with Dupuytren's and CRPS-I after collagenase clostridium histolyticum injection is encouraging [16].

Assessment and Prognosis

  • Early recognition and prompt treatment are important to minimize permanent loss of function in CRPS [9].

Key Considerations

Diagnosis and Pathophysiology

  • The reported incidence of CRPS is influenced by choice of diagnostic criteria, along with the study location and/or how the fracture is managed [15].

Risk Factors and Incidence

Treatment

  • High-intensity laser therapy and mirror therapy offer conclusive evidence of pain reduction in CRPS-I, even after the third treatment session [7].
  • A positive outcome was observed for a patient with Dupuytren's contracture and CRPS-I after collagenase clostridium histolyticum injection [16].

Prognosis and Assessment

Key Evidence

  • [L1] In patients presenting with chronic or refractory CRPS, strong consideration should be given for the use of ketamine. [1] (10.1177/15589447221131847)
  • [L3] A more active treatment approach seems to lower the incidence of CRPS-1. [2] (10.1177/1558944719895782)
  • [L4] CRPS is a multifactorial condition that still requires further studying to better understand its pathogenesis, epidemiology, genetic involvement, psychological implications, and treatment options. [3] (10.1007/s40122-021-00279-4)
  • [L4] It can be relied upon to assess CRPS symptoms, functional limitations, and psychosocial impacts. [4] (10.1016/j.jht.2025.02.004)
  • [L1] The systematic review and meta-analysis of quantitative sensory testing outcomes indicates altered pain mechanisms in complex regional pain syndrome compared to controls, with a pooled standardized mean difference of -0.41. [5] (10.1186/s13018-022-03461-2)
  • [L4] The report emphasizes the importance of recognizing CRPS and highlights the potential of prednisolone as a treatment option, particularly in resource-limited settings where more specialized interventions may be unavailable. [6] (10.1186/s12891-024-07333-0)
  • [L1] The study results offer conclusive evidence of pain reduction, a highly debilitating symptom in CRPS-I, even after the third HILT treatment session. [7] (10.1016/j.jht.2025.02.009)
  • [L1] Methodological quality of non-pharmacological treatment approaches for upper limb CRPS is overall poor. [8] (10.1177/17589983221138610)
  • [L2] CRPS following isolated CuTS is exceedingly rare, with an overall 1-year incidence rate of approximately 0.33%. [10] (10.1016/j.jhsg.2026.101028)
  • [L3] Female sex and release of more than one digit are significant predictors of developing CRPS. [11] (10.1177/1558944720963915)
  • [L3] This study demonstrates that a large percentage of patients diagnosed with and treated for CRPS type 1 can have full resolution of their symptoms with carpal tunnel release. [12] (10.1016/j.jhsa.2024.09.024)
  • [L3] The occurrence of CRPS is the result of many factors, with elderly patients, females, and manual laborers having higher risks. [13] (10.1186/s12891-024-07948-3)
  • [L3] CRPS-related hand lesions developed in 19.4% of patients following ARCR. [14] (10.5397/cise.2021.00080)
  • [L1] The reported incidence of CRPS is influenced by choice of diagnostic criteria, along with the study location and/or how the fracture is managed. [15] (10.1177/1758998320910179)
  • [L4] The positive outcome for this woman with Dupuytren's and CRPS-I after CCH injection is encouraging. [16] (10.1016/j.jht.2024.09.002)
  • [L3] Preexisting neuropathic disorders, particularly traumatic nerve injuries, compressive neuropathies, and cervical radiculopathy, are the strongest predictors of CRPS after distal radius fracture. [17] (10.1016/j.jhsa.2026.01.004)
  • [L5] This case report suggests that the topical application of doxepin may represent a simple option for the management of CRPS. [18] (10.1016/s0020-1383(01)00054-7)
  • [Case_report] Glomus tumors should be included in the differential diagnosis for patients with unusual chronic pain or neuropathy, and the diagnosis of CRPS should only be a diagnosis of exclusion. [19] (10.1177/1558944719895618)
  • [L2] Patients suffering from scaphoid waist fracture may be at a higher risk of CRPS I, especially in women with diabetes mellitus who report severe pain before treatment. [20] (10.1186/s12891-021-04977-0)

References

[1] Pharmacologic Treatments in Upper Extremity Complex Regional Pain Syndrome: A Review and Analysis of Quality of Evidence. HAND. 2022. DOI: 10.1177/15589447221131847

[2] Treatment of Distal Radius Fracture: Does Early Activity Postinjury Lead to a Lower Incidence of Complex Regional Pain Syndrome?. HAND. 2020. DOI: 10.1177/1558944719895782

[3] Complex Regional Pain Syndrome: A Comprehensive Review. Pain and Therapy. 2021. DOI: 10.1007/s40122-021-00279-4

[4] Psychometric evaluation of the Hamilton Inventory to evaluate signs and symptoms in patients with Complex Regional Pain Syndrome (CRPS). Journal of Hand Therapy. 2025. DOI: 10.1016/j.jht.2025.02.004

[5] Pain mechanisms in complex regional pain syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes. Journal of Orthopaedic Surgery and Research. 2023. DOI: 10.1186/s13018-022-03461-2

[6] Complex regional pain syndrome: diagnostic challenges and favorable response to prednisolone. BMC Musculoskeletal Disorders. 2024. DOI: 10.1186/s12891-024-07333-0

[7] Effect of high-intensity laser therapy and mirror therapy on complex regional pain syndrome type I in the hand area: A randomized controlled trial. Journal of Hand Therapy. 2025. DOI: 10.1016/j.jht.2025.02.009

[8] Person-centred management of upper limb complex regional pain syndrome: an integrative review of non-pharmacological treatment. Hand Therapy. 2023. DOI: 10.1177/17589983221138610

[9] Complex Regional Pain Syndrome. 2021.

[10] Incidence and Patient-Level Risk Factors for Complex Regional Pain Syndrome Following Cubital Tunnel Surgery. Journal of Hand Surgery Global Online. 2026. DOI: 10.1016/j.jhsg.2026.101028

[11] Separating Fact From Fiction: A Nationwide Longitudinal Examination of Complex Regional Pain Syndrome Following Treatment of Dupuytren Contracture. HAND. 2020. DOI: 10.1177/1558944720963915

[12] Outcomes of Median Nerve Release in Complex Regional Pain Syndrome Type 1 of the Hand: A Prospective Case Series. The Journal of Hand Surgery. 2025. DOI: 10.1016/j.jhsa.2024.09.024

[13] Dynamic risk factors for complex regional pain syndrome after distal radius fracture surgery: multivariate analysis and prediction. BMC Musculoskeletal Disorders. 2024. DOI: 10.1186/s12891-024-07948-3

[14] Clinical outcome in patients with hand lesions associated with complex regional pain syndrome after arthroscopic rotator cuff repair. Clinics in Shoulder and Elbow. 2021. DOI: 10.5397/cise.2021.00080

[15] What is the incidence of complex regional pain syndrome (CRPS) Type I within four months of a wrist fracture in the adult population? A systematic review. Hand Therapy. 2020. DOI: 10.1177/1758998320910179

[16] The case of a woman with bilateral Dupuytren’s contractures who developed CRPS-1 after fasciectomy with no relapse on subsequent collagenase clostridium histolyticum injection and manipulation of the other hand: Considerations for implementing a Budapest criteria checklist and assessing vasomotor instability by measuring differences in skin temperature. Journal of Hand Therapy. 2025. DOI: 10.1016/j.jht.2024.09.002

[17] A Nationwide Propensity Score-Matched Analysis Identifying Preinjury Predictors of Complex Regional Pain Syndrome Following Distal Radius Fracture. The Journal of Hand Surgery. 2026. DOI: 10.1016/j.jhsa.2026.01.004

[18] Topical application of doxepin hydrochloride can reduce the symptoms of complex regional pain syndrome: a case report. Injury. 2002. DOI: 10.1016/s0020-1383(01)00054-7

[19] An Unusual Case of Periosteal Glomus Tumor at the Metacarpal Base Presenting as Type II CRPS: Case Report. HAND. 2020. DOI: 10.1177/1558944719895618

[20] Determinants of complex regional pain syndrome type I in patients with scaphoid waist fracture- a multicenter prospective observational study. BMC Musculoskeletal Disorders. 2022. DOI: 10.1186/s12891-021-04977-0

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4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

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