Complex regional pain syndrome (CRPS): pathophysiological aspects

Objective. To analyze modern data on CRPS, its complexities and pathophysiological mechanisms, as well as treatment of this debilitating illness. Material and methods. The eLibrary, PubMed, Springer, Cyberleninka databases were screened over the last 5—8 years. The review presents modern information on diverse pathophysiological mechanisms of CRPS (neural, inflammatory, vascular, immune aspects, as well as independent triggers). Various reviews, including systemic ones were preferable. Studies published more than 5 years ago were used in historical aspect or in case of description of important experimental results. Results. The article describes such aspects of CRPS as genetic predisposition, trauma, microcirculatory disorders, impaired autonomic dysfunction, inflammation, oxidative stress and autoimmune pathology. Conclusion. CRPS is characterized by inter-individual heterogeneity and even intra-individual variability. Thus, both genetic predisposition and environmental influences contribute to CRPS, and patients have changes in peripheral and central nervous system. Inflammation and neuroimmune interactions are essential in CRPS. Autoimmune mechanisms include IgG-mediated neuroinflammation and IgM-mediated enhancement of nociception.