Complex regional pain syndrome (CRPS) and children: what paediatricians should know

Key words: Complex regional pain syndrome, Algodystrophy, Children, Pain

Complex regional pain syndrome (CRPS) is a debilitating pain condition characterized by continuous and severe pain that usually affects a limb. The syndrome is well-described in adults, but can also affect children and adolescents. Symptoms include disproportionate pain, allodynia and hyperalgesia; clinical signs are swelling or oedema, changes in skin’s colour, temperature and tropism, hyperhidrosis and motor disturbances of the affected limb. The exact pathogenesis of CRPS is unknown, although several different mechanisms have been suggested. The diagnosis is clinical: the adult criteria for CRPS and imaging showing localized osteoporosis can be useful. Treatment of CRPS in children consists of a multidisciplinary approach combining physical, psychological and pharmacological therapies: the main goal is early mobilization of the affected limb through intensive physiotherapy. Drugs reducing physical and neuropathic pain may be helpful to perform the exercises; also patients’ families and cognitive-behavioural support can play an important role in the remission of the syndrome. The prognosis in paediatric CRPS is favourable, however relapses are common.