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Complex Regional Pain Syndrome — RACP Adult Medicine MCQ

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HardRheumatologyComplex Regional Pain SyndromeRACP Adult Medicine

A 50-year-old woman presents with complex regional pain syndrome type 1 (CRPS-1) of the left hand following a distal radius fracture 6 months ago. She has allodynia, oedema, colour changes, temperature asymmetry, and sudomotor changes. X-ray shows patchy osteopenia. Pain is 9/10. What is the most important treatment component?

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Correct answer: D — Intensive physiotherapy and graded motor imagery

CRPS-1 management centres on intensive physiotherapy and rehabilitation — this is the most important treatment component. Graded motor imagery (mirror therapy), desensitisation, and progressive loading are evidence-based. Pharmacotherapy is adjunctive: neuropathic pain agents (gabapentin, amitriptyline), bisphosphonates (for bone pain/osteopenia), short-course prednisolone (for acute inflammatory CRPS), and vitamin C (may reduce CRPS risk post-fracture). Multidisciplinary pain management is essential.

Reference: Faculty of Pain Medicine ANZCA – 2024; Budapest Criteria for CRPS