Treatment of Complex Regional Pain Syndrome in Children and Adolescents: A Structured Literature Scoping Review

Abstract

Background: Complex regional pain syndrome (CRPS) is characterized by chronic, spontaneous and provoked pain of the distal extremities whose severity is disproportionate to the triggering event. Diagnosis and treatment are still debated and multidisciplinary. The purpose of this systematic review is to analyze the available literature to provide an update on the latest evidence related to the treatment of CRPS in growing age. Methods: Data extraction was performed independently by three reviewers based on predefined criteria and the methodologic quality of included studies was quantified by the Newcastle–Ottawa Quality Assessment Scale Cohort Studies. Results: At the end of the first screening, following the previously described selection criteria, we selected n = 103 articles eligible for full-text reading. Ultimately, after full-text reading and a reference list check, we selected n = 6. The articles focused on physical (PT), associated with cognitive behavioral (CBT) and pharmacological (PhT) treatments. The combination of PT + CBT shows the most efficacy as suggested, but a commonly accepted protocol has not been developed. Conclusions: Physical therapy in association with occupational and cognitive behavioral treatment is the recommended option in the management of pediatric CPRS. Pharmacological therapy should be reserved for refractory and selected patients. The design and development of a standard protocol are strongly suggested.