Chronic Regional Pain Syndrome in the Geriatric Patient

Complex regional pain syndrome (CRPS) is a chronic pain condition that affects the extremities, believed to be caused by damage to, or malfunction of, the peripheral and central nervous systems. And while CRPS is its own unique disease entity, its potential pathophysiological mechanisms have frequently been compared to those of neuropathy and fibromyalgia (FM). Furthermore, treatment of CRPS has proven difficult given the fact that its unverified pathophysiology and variable presentation make accurate clinical diagnosis challenging. The geriatric population is considered those 65 years of age and older. And although CRPS can occur at any age it does occur in geriatric individuals, yet there are very limited published data specifically involving this population. Surprisingly, some reports suggest that CRPS is most prevalent among the elderly (65+), yet it is underreported. This may be due to the wide variety of terminology used to describe CRPS, overlap of CRPS with other pain conditions, and even comorbidities in geriatric patients. Currently, the literature lacks high-quality evidence to guide treatment of CRPS, especially in geriatric patients, and patients even with known diagnoses continue to suffer refractory pain. Therefore, since there are limited data involving CRPS and the elderly, this chapter will attempt to extrapolate relevant information from resources involving chronic pain in the elderly and CRPS in the elderly. Overall, there is a gap in the literature involving this patient population and more published studies are necessary to address this gap.