Complex regional pain syndrom

What is CRPS?

Pain is an essential “detect and protect” mechanism against threatening events, which requires a highly coordinated network of molecular signals in the skin, where resident cells interplay with the immune and nervous systems. Disruption of these pathways may lead to intense suffering and disability. A prime example includes Complex Regional Pain Syndrome (CRPS), a painful condition normally affecting the extremities after an injury or surgery.

CRPS is also accompanied by chronic inflammation, sudomotor, vasomotor, trophic and motor disturbances, and psychological signs. Currently, there are two known CRPS types; in type I, direct nerve damage in the affected limb remains absent, whereas type II shows clear nerve impairment. Considered as a rare disease, CRPS has an incidence of 26 in 100,000 people per year, with type I being the most prevalent.

Treatments for CRPS, including rehabilitation, psychotherapy and medications for pain and inflammation, aim to improve the quality of life by tackling the symptoms rather than the underlying condition. If not monitored correctly, CRPS can rapidly progress from initial functional changes to late muscle deterioration and central nervous system reorganisation, thus, the earlier the diagnosis the better the outcome. Despite this, CRPS early diagnosis still represents a challenge as it remains strictly clinical, relying mainly on a “signs and symptoms” system known as the Budapest Criteria.

To provide correct diagnosis and successful therapy for all patients, research in molecular mechanisms and pain phenotyping of CRPS is urgently needed. Therefore, our main goal is to understand the precise pathogenesis of this condition, focusing on the epidermal communication between specific neuronal and non-neuronal cells in CRPS skin.