Evidence map›Paper›PMID 36482756›Full record

ArticleDeutsches Arzteblatt international2022

Modern Principles of Diagnosis and Treatment in Complex Regional Pain Syndrome.

Alexandra Melf-Marzi, Bettina Böhringer, Matthias Wiehle, Constanze Hausteiner-Wiehle

Open access · greenAbstract read
In one paragraph

Article in Deutsches Arzteblatt international, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed
5.6field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 25 citations in OpenAlex.

  1. Cognitive Function in Patients With Complex Regional Pain Syndrome (CRPS).European journal of pain (London, England) · 2025
    Trial
  2. Article
  3. Observational
  4. Article
  5. Complex regional pain syndrome in a living kidney donor.Revista da Associacao Medica Brasileira (1992) · 2026
    Article
  6. Review
  7. Article
  8. Review
  9. Review
  10. Review
  11. Article
  12. Article
  13. The Treatment of Closed Finger and Metacarpal Fractures.Deutsches Arzteblatt international · 2023
    Review
  14. Additions Required.Deutsches Arzteblatt international · 2023
    Article
  15. Complex Pathophysiology and Differentiated Therapy.Deutsches Arzteblatt international · 2023
    Article
  16. In Reply.Deutsches Arzteblatt international · 2023
    Article
  17. Confusing and Substantially Overinterpreted.Deutsches Arzteblatt international · 2023
    Article
  18. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Alexandra Melf-MarziDepartment for BG Rehabilitation; Outpatient CRPS Clinic; BG Trauma Center Murnau; Department for Anesthesiology, Intensive Care Medicine and Pain Therapy; Multimodal Pain Therapy; BG Trauma Center Murnau; Department for Neurology, Clinical Neurophysiology and Stroke Unit; BG Trauma Center Murnau; Clinic and Polyclinic for Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich.
Bettina Böhringer
Matthias Wiehle
Constanze Hausteiner-Wiehle
Berufsgenossenschaftliche Unfallklinik Murnau · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBackground: Complex regional pain syndrome (CRPS) is a relatively common complication, occurring in 5% of cases after injury or surgery, particularly in the limbs. The incidence of CPRS is around 5-26/100 000. The latest revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-11) now categorizes CRPS as a primary pain condition of multifactorial origin, rather than a disease of the skeletal system or the autonomic nervous system.

methodsMethod: Based on a selective search of the literature, we summarize current principles for the diagnosis and treatment of CRPS.

resultsResults: Regional findings in CRPS are accompanied by systemic symptoms, especially by neurocognitive disorders of body perception and of symptom processing. The therapeutic focus is shifting from predominantly passive peripheral measures to early active treatments acting both centrally and peripherally. The treatment is centered on physiotherapy and occupational therapy to improve sensory perception, strength, (fine) motor skills, and sensorimotor integration/ body perception. This is supported by stepped psychological interventions to reduce anxiety and avoidance behavior, medication to decrease inflammation and pain, passive physical measures for reduction of edema and of pain, and medical aids to improve functioning in daily life. Interventional procedures should be limited to exceptional cases and only be performed in specialized centers. Spinal cord and dorsal root ganglion stimulation, respectively, are the interventions with the best evidence.

conclusionConclusion: The modern principles for the diagnosis and treatment of CRPS consider both, physiological and psychological mechanisms, with the primary goal of restoring function and participation. More research is needed to strengthen the evidence base in this field.

Indexed as

Complex Regional Pain SyndromesExtremitiesHumansPainPain MeasurementPhysical Therapy Modalities

Identifiers

PMID36482756
PMCPMC10011717
OpenAlexW4310958325

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.