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پیچیدہ علاقائی درد سنڈروم (CRPS)

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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
ایک نرم ہال کے ساتھ ایک ہاتھ بڑھتی ہوئی حساسیت کا مشورہ دیتے ہیں.
سی آر پی ایس میں ایک عضو شدید تکلیف دہ ، سوجن اور حساس بن سکتا ہے جو اصل چوٹ کے تناسب سے باہر ہے۔ Kieran Hirpara 4.0

اس صفحے کا ترجمہ مشین سے کیا گیا ہے اور ابھی تک کسی ڈاکٹر نے اس کی جانچ نہیں کی۔ انگریزی نسخہ ہی مستند ہے۔

آپ کیا محسوس کر رہے ہیں

پیچیدہ علاقائی درد کا سنڈروم (سی آر پی ایس) ایک ایسی حالت ہے جہاں چوٹ یا سرجری کے بعد درد اور دیگر علامات جاری رہتے ہیں ، اکثر ایسے طریقوں سے جو اصل مسئلے کے تناسب سے باہر نظر آتے ہیں۔ یہ آپ کے ہاتھ یا بازو کو کسی فریکچر یا آپریشن کے بعد متاثر کر سکتا ہے، اور یہ کسی ایک چیز کی بجائے متعدد وجوہات کی وجہ سے ہوتا ہے۔

بنیادی علامت درد ہے. یہ شدید اور نالی ہو سکتا ہے، اور یہ اس جگہ سے باہر پھیل سکتا ہے جہاں آپ کو زخمی کیا گیا تھا. درد اکثر رات کو یا آپ کے ہاتھ کو استعمال کرنے کے بعد بھڑکتا ہے، اور جب آپ جاگتے ہیں تو یہ وہاں ہوسکتا ہے. [ صفحہ ۲۲ پر تصویر] ہاتھ کو آرام دینا اسے تھوڑا سا آرام دے سکتا ہے، لیکن درد اب بھی باقی رہ سکتا ہے۔

روزمرہ کے کام مشکل ہو سکتے ہیں۔ [ صفحہ ۱۲ پر تصویر] [ صفحہ ۲۱ پر تصویر] کچھ لوگ محسوس کرتے ہیں کہ وہ ہاتھ استعمال کرنے سے گریز کرتے ہیں کیونکہ وہ اس درد سے ڈرتے ہیں جو یہ لاتا ہے۔

سی آر پی ایس کی تشخیص آپ کی تاریخ اور جسمانی معائنہ سے کی جاتی ہے، نہ کہ ایک ہی اسکین یا خون کے ٹیسٹ سے۔ آپ کا ڈاکٹر CRPS کی وضاحت کے طور پر حل کرنے سے پہلے جاری درد کی دیگر وجوہات کی بھی جانچ کرے گا.

اسے پہچاننا اور ابتدائی معاملات کا علاج کرنا۔ فوری علاج حرکت اور کام کے دیرپا نقصان کا امکان کم کرتا ہے. [ صفحہ ۲۲ پر تصویر]

کچھ لوگوں کو دوسروں کے مقابلے میں سی آر پی ایس کا زیادہ خطرہ ہوتا ہے۔ خواتین، بوڑھے افراد اور بھاری جسمانی کام کرنے والوں کو کلائی کے فریکچر کی سرجری کے بعد زیادہ خطرات کا سامنا کرنا پڑتا ہے۔ موجودہ اعصابی مسائل، جیسے ایک پھنسے ہوئے اعصاب یا گردن اعصابی مسئلہ، خطرے کو مزید بڑھاتا ہے. Dupuytren معاہدے کے لئے سرجری کے بعد، خواتین اور ان لوگوں کو ایک سے زیادہ انگلیوں کو آزاد کرنے کے بعد اسے تیار کرنے کا امکان زیادہ ہے.

اگر آپ کا درد غیر معمولی محسوس ہوتا ہے یا توقع کے مطابق ٹھیک نہیں ہوتا ہے تو اپنے ڈاکٹر کو وقت سے پہلے بتائیں۔

اصل میں کیا ہو رہا ہے

سی آر پی ایس وہ نقصان نہیں ہے جو آپ اسکین پر دیکھ سکتے ہیں۔ آپ کی ہڈی یا ٹشو کی چوٹ ٹھیک ہو رہی ہو سکتی ہے، لیکن آپ کے جسم کا درد پر قابو پانے کا طریقہ بدل گیا ہے۔ اعصاب اور دماغ پہلے سے مختلف طریقے سے درد کے سگنل بھیجتے اور پڑھتے ہیں، اس لیے ایک ہاتھ جو باہر سے اچھا لگتا ہے اسے جلتا ہوا، نرم، یا استعمال کرنے میں تکلیف محسوس ہو سکتی ہے۔

اس کے بارے میں سوچو جیسے دھواں الارم جو بہت حساس ہو گیا ہے. ایک چھوٹا سا دھواں مکمل الارم کو متحرک کرتا ہے، اور اسی طرح، ہلکی چھوٹ یا ہلکی حرکت شدید درد کو متحرک کر سکتی ہے۔ [ صفحہ ۲۱ پر تصویر]

چونکہ درد کے اشارے خود ہی بدل گئے ہیں، اس لیے سی آر پی ایس کا پتہ لگانے کے لیے اسکین اور خون کے ٹیسٹ قابل اعتماد نہیں ہیں۔ کوئی واحد ٹیسٹ نہیں ہے جو اس کی تصدیق کرے۔ اس کے بجائے، آپ کا ڈاکٹر آپ کی تاریخ اور معائنہ کے ذریعے کام کرتا ہے، اور پہلے دوسرے وجوہات کو خارج کرتا ہے. سی آر پی ایس کی تشخیص صرف اس وقت کی جاتی ہے جب دیگر وضاحتوں کو خارج کر دیا گیا ہو ، یہی وجہ ہے کہ آپ کو گلوماس ٹیومر جیسی چیزوں کی جانچ پڑتال کی جاسکتی ہے ، ناخن کے نیچے چھوٹی چھوٹی خون کی وریدوں میں ایک چھوٹی سی نمو جو غیر معمولی جاری درد کا سبب بن سکتی ہے۔

یہ حالت پیچیدہ ہے، اور اس کی صحیح وجوہات کا ابھی تک مطالعہ کیا جا رہا ہے۔ کیا جانا جاتا ہے کہ کئی چیزیں مل کر اسے متحرک کر سکتی ہیں۔ موجودہ اعصابی مسائل، جیسے ایک پھنسے ہوئے اعصاب یا گردن اعصابی مسئلہ، کلائی فریکچر سرجری کے بعد سب سے مضبوط پیش گو ہیں. فریکچر سے پہلے علاج کی جانے والی جذباتی پریشانی، جیسے اضطراب یا ڈپریشن، علاج کے دوران سی آر پی ایس کے ہونے کے امکانات کو تقریباً دوگنا کر دیتی ہے۔ خواتین، عمر رسیدہ افراد، اور بھاری جسمانی کام کرنے والوں کو بھی زیادہ خطرات کا سامنا ہے۔

اس کا جلد پتہ لگانا اہم ہے کیونکہ فوری علاج سے تحریک کے دیرپا نقصان کا امکان کم ہوجاتا ہے۔ [ صفحہ ۲۲ پر تصویر]

ہم اس کے بارے میں کیا کر سکتے ہیں

بہت کچھ ہے جو آپ خود کر سکتے ہیں، اور یہ عام طور پر حرکت سے شروع ہوتا ہے۔ ہاتھ اور بازو کو کام کرتے رکھنا علاج کا ایک مرکزی حصہ ہے ، اور فزیوتھراپی کا مقصد ہاتھ کو استعمال کرنے میں نقل و حرکت ، طاقت اور اعتماد کی بحالی ہے۔ [ صفحہ ۳ پر تصویر] [ صفحہ ۳ پر تصویر] بحالی کے لئے زیادہ فعال نقطہ نظر بھی پہلی جگہ میں چوٹ کے بعد CRPS کی ترقی کے موقع کو کم کرتا ہے. اس نقطہ نظر کو دنوں کے بجائے ہفتوں تک منصفانہ طور پر دیں ، اور جب پیشرفت سست محسوس ہو تو بھی جاری رکھیں۔ کچھ لوگوں کو آئینے کی تھراپی بھی مددگار معلوم ہوتی ہے ، جہاں آپ آئینے میں دیکھتے ہوئے اپنے غیر متاثرہ ہاتھ کو حرکت دیتے ہیں ، اور آپ کا معالج درد کو کم کرنے کے لئے لیزر تھراپی جیسے دیگر علاج کا استعمال کرسکتا ہے۔

اگر خود انتظام کافی نہیں ہے، ادویات ہیں جو مدد کر سکتے ہیں. درد کی ادویات اور سوزش کے خلاف ادویات فلیئرس کو حل کر سکتے ہیں اور تحریک کو زیادہ آرام دہ بنا سکتے ہیں، جو اہم ہے کیونکہ ہاتھ کو منتقل کرنا بنیادی علاج ہے۔ آپ کا ڈاکٹر سٹیرائڈ گولیوں کا ایک مختصر کورس بھی تجویز کرسکتا ہے ، جیسے پریڈنیسولون ، جو سوزش کو پرسکون کرتا ہے اور علامات کو کم کرسکتا ہے ، خاص طور پر جب ماہر علاج تک رسائی مشکل ہو۔ جلد پر براہ راست لگائے جانے والے اختیارات بھی موجود ہیں ، جیسے دواؤں والی کریم ، جو درد کو سنبھالنے کا ایک آسان طریقہ پیش کرتی ہے۔ سخت حالتوں میں، کچھ لوگوں کو ہسپتال میں کیٹامین انفیوژن کی پیشکش کی جاتی ہے، جو خود درد کے راستوں پر کام کرتا ہے۔ ان میں سے ہر ایک کے ضمنی اثرات کے بارے میں تجارت ہے اور فائدہ کب تک رہتا ہے ، لہذا یہ بات کرنے کے قابل ہے کہ آپ کے لئے کیا مناسب ہے۔

اگر آپ کے علامات شدید ہیں اور مذکورہ بالا اقدامات کے باوجود اب بھی حل نہیں ہوتے ہیں تو ، کسی ماہر سے ملنے کے بارے میں پوچھیں۔ ایک ڈاکٹر آپ کو ماہر تشخیص کے لئے بھیج سکتا ہے، اور بعض مخصوص بنیادی مسائل کے لئے، ایک طریقہ کار کبھی کبھار غور کیا جا سکتا ہے. مثال کے طور پر ، جہاں مٹھی میں پھنسے ہوئے اعصاب علامات کو چلاتے ہیں ، اسے چھوڑنا بہت سے لوگوں کے لئے مکمل حل کا باعث بن سکتا ہے ، اور سخت جوڑوں کو جو معاہدہ کیا گیا ہے اسے آہستہ آہستہ آزاد کیا جاسکتا ہے اور پھر اس کی مدد کی جاسکتی ہے۔ یہ فیصلے کیس بہ کیس کئے جاتے ہیں، ایک بار جب دیگر وجوہات کو خارج کر دیا گیا ہے جیسا کہ پہلے بیان کیا گیا ہے. جتنا جلد سی آر پی ایس کو پہچانا جائے گا اور اس کا علاج کیا جائے گا، اتنا ہی بہتر موقع ہے کہ حرکت کی مستقل کمی سے بچا جا سکے، لہذا مدد حاصل کرنے میں تاخیر نہ کریں۔

کیا توقع کریں

سی آر پی ایس کے ساتھ ہر ایک کا کورس تھوڑا مختلف ہے ، اور کوئی مقررہ ٹائم لائن نہیں ہے جس پر آپ انحصار کرسکتے ہیں۔ کچھ لوگوں میں یہ علامات ہفتوں یا مہینوں میں ختم ہو جاتی ہیں، خاص طور پر جب علاج جلد شروع کیا جائے۔ دوسروں کے لئے درد زیادہ دیر تک رہتا ہے، اور کچھ لوگوں کو ابتدائی دیکھ بھال کے بعد بھی کچھ مستقل خرابی یا معذوری کے ساتھ چھوڑ دیا جاتا ہے. ابتدائی شناخت اور فوری علاج آپ کو تحریک کے دیرپا نقصان سے بچنے کا بہترین موقع فراہم کرتا ہے ، یہی وجہ ہے کہ مدد حاصل کرنے میں تاخیر نہ کرنا ضروری ہے۔

اگر اس کو اچھی طرح سے سنبھالا جائے تو یہ ایک اچانک فکس کے بجائے مستقل بہتری کا امکان ہے۔ ہاتھ کو حرکت دینا، یہاں تک کہ جب اسے تھوڑا سا درد ہو، تو پہلے بیان کردہ زیادہ حساس درد کے اشاروں کو پرسکون کرنے میں مدد ملتی ہے، اور ترقی عام طور پر ہفتوں اور مہینوں میں آہستہ آہستہ بنتی ہے۔ کچھ علاج راستے میں ایک حقیقی فرق کر سکتے ہیں. آئینہ تھراپی اور لیزر تھراپی درد کو کم کر سکتی ہے، کبھی کبھی پہلے چند سیشنوں کے اندر. جہاں مٹھی میں پھنسے ہوئے اعصاب علامات کو چلاتے ہیں ، اسے چھوڑنے سے بہت سے لوگوں کے لئے علامات کا مکمل خاتمہ ہوسکتا ہے۔ سخت جوڑوں کو جو معاہدہ ہوچکا ہے اسے آہستہ آہستہ آزاد کیا جاسکتا ہے اور پھر اس کو اسپلٹ کیا جاسکتا ہے ، جو اچھی طرح سے چلتا ہے۔

اگر اسے اکیلا چھوڑ دیا جائے تو، تصویر کم یقینی ہے. درد کی شدت میں اضافہ ہو سکتا ہے، اور دیرپا سختی اور کام کرنے کی صلاحیت کے ضائع ہونے کا امکان بڑھتا ہے جیسے جیسے معاملات بڑھتے جاتے ہیں. شدید، دیرینہ معاملات میں جو کسی دوسرے علاج کا جواب نہیں دیتے، کبھی کبھی سرجری کو آخری حربہ سمجھا جاتا ہے۔ شدید جاری اعصابی درد کے ساتھ لوگوں کی ایک چھوٹی سی تعداد کے لئے ، گھٹنے کے نیچے سے نیچے کی ٹانگ کو ہٹانے سے معنی خیز درد میں راحت اور قابل قبول کام آیا ہے۔ یہ ایک عام راستہ نہیں ہے، اور یہ صرف وزن کیا جاتا ہے سب کچھ کرنے کی کوشش کی گئی ہے کے بعد.

سی آر پی ایس کی وجوہات کیا ہیں؟ جو ہم جانتے ہیں وہ یہ ہے کہ فعال رہنا، جلد علاج کروانا، اور اپنی دیکھ بھال کرنے والی ٹیم کے ساتھ کام کرنا آپ کو سب سے مضبوط بنیاد فراہم کرتا ہے۔ اپنی توقعات کو آہستہ آہستہ ترقی پر رکھیں، ایک فوری حل نہیں، اور راستے میں اپنے ڈاکٹر کے ساتھ کوئی غیر معمولی چیز اٹھائیں.

کسی سے کب ملنا ہے

اگر کسی چوٹ یا سرجری کے بعد درد رات کو بھڑکتا رہتا ہے، زخمی جگہ سے باہر پھیل جاتا ہے، یا خود چوٹ سے کہیں زیادہ مضبوط محسوس ہوتا ہے تو اپنے جی پی یا ڈاکٹر سے جلد رجوع کریں۔ اگر ہلکا سا چھونا، ہلکی سی حرکت یا درجہ حرارت میں تبدیلی شدید درد کا سبب بنتی ہے، یا اگر آپ کا ہاتھ اتنا تکلیف دہ ہو گیا ہے کہ آپ اسے استعمال کرنے سے گریز کرتے ہیں تو مدد طلب کریں۔ سی آر پی ایس کی جلد تشخیص اور علاج سے تحریک کے دیرپا نقصان کا امکان کم ہوجاتا ہے ، لہذا علامات کے خود بخود حل ہونے کا انتظار نہ کریں۔ چونکہ سی آر پی ایس کی تشخیص صرف اس وقت کی جاتی ہے جب دیگر وجوہات کو خارج کر دیا جاتا ہے، غیر معمولی جاری درد کو ہمیشہ اصل چوٹ کے بجائے چیک کیا جانا چاہئے۔

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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