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A Web-Based Cross-Sectional Epidemiological Survey of Complex Regional Pain Syndrome
  1. Amit Sharma, MD*,
  2. Shefali Agarwal, MPH,
  3. James Broatch, MSW and
  4. Srinivasa N. Raja, MD
  1. From the *Department of Anesthesiology, College of Physicians & Surgeons of Columbia University, New York, NY;
  2. Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University, Baltimore, MD; and
  3. The Reflex Sympathetic Dystrophy Syndrome Association of America, Milford, CT.
  1. Address correspondence to: Srinivasa N. Raja, MD, Johns Hopkins Hospital, 600 N Wolfe St, Osler 292, Baltimore, MD 21287-5354 (e-mail: sraja2{at}


Background and Objectives: Complex regional pain syndrome (CRPS) is a poorly understood pain disorder with little information on the natural course of the disease. Changes in its diagnostic criteria have simplified the identification of this syndrome, but convincing epidemiological data regarding this disorder are still lacking. Here, we collected epidemiological and other relevant information regarding CRPS via a Web-based survey to develop a better understanding of the epidemiology, symptoms, progression, therapy, and associated psychosocial factors related to CRPS.

Methods: A survey of 75 questions was hosted on the Web site of the Reflex Sympathetic Dystrophy Syndrome Association of America for 5 months. One thousand three hundred fifty-nine subjects responded, and 888 of these satisfied the inclusion criteria for CRPS and were accepted for data analysis.

Results: Complex regional pain syndrome affected mostly white women in the 25- to 55-year-old age group. It was often precipitated by trauma (surgical or nonsurgical) and commonly involved the lower (∼56%) and upper (∼38%) extremities. Pain was usually accompanied by edema, vasomotor, sudomotor, motor, and trophic changes. The syndrome commonly progressed and spread to involve other body areas. Affected patients failed multiple pharmacological and nonpharmacological interventions. The syndrome frequently interfered with job (∼62% disability rate), sleep (∼96%), mobility (∼86%), and self-care (∼57%). Remissions and relapses were both common.

Conclusions: Complex regional pain syndrome is a severe disabling pain disorder that results in physical as well as emotional and financial consequences to patients. The disease complexity requires coordination of multidisciplinary care that can be achieved by educational efforts directed to general practitioners.

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  • Drs. Sharma and Agarwal contributed equally to the work.

  • This study was funded in part by grant support from the Reflex Sympathetic Dystrophy Syndrome Association of America.