Complex regional pain syndrome (CRPS) is a chronic pain illness characterized by ongoing discomfort, sensory abnormalities, motor dysfunction, edema, and decreased functional capacity. Although different therapeutic options have been presented, the efficacy of physical rehabilitation and pharmaceutical therapies is still under research. This systematic review sought to assess the existing data on the efficacy of physiotherapy rehabilitation and pharmaceutical therapies in improving pain, function, and quality of life in people with CRPS. A systematic review of randomized controlled trials (RCTs) published between 2016 and 2024 was conducted. Electronic databases, including PubMed, Scopus, PEDro, Cochrane Library, and Google Scholar, were searched. RCTs published in English that investigated physiotherapy rehabilitation or pharmacological interventions for CRPS were included. Fourteen studies met the eligibility criteria. Methodological quality was assessed using a standardized risk-of-bias assessment tool. Due to heterogeneity among interventions and outcome measures, a narrative synthesis was performed. Fourteen RCTs met the inclusion criteria. Overall, interventions demonstrated improvements in pain, functional capacity, and quality of life; however, the magnitude and consistency of treatment effects varied substantially across studies. The results imply that current CRPS therapeutic options may improve pain, function, and quality of life; however, treatment efficacy differs between trials. Key obstacles include diverse clinical presentations, a lack of defined treatment methods, and insufficient long-term data. Future research should focus on creating standardized diagnostic criteria, accurate biomarkers, personalized treatment techniques, and large-scale clinical trials to enhance patient outcomes. The findings indicate that physiotherapy rehabilitation is important in the treatment of CRPS and can successfully improve pain and functional performance. Neridronate appeared to be the most promising pharmaceutical strategy in the research reviewed. However, the heterogeneity in treatment methods, outcome measures, and sample sizes restricts the generalizability of the results. More large-scale, high-quality randomized controlled studies are needed to provide uniform treatment guidelines and maximize clinical outcomes in patients with CRPS.

[This corrects the article DOI: 10.3389/fneur.2026.1857245.].

Reflex sympathetic dystrophy (RSD), currently categorized within the spectrum of complex regional pain syndrome (CRPS), is typically considered an acquired disorder characterized by disproportionate pain, erythema, and autonomic changes. In contrast, inherited erythromelalgia is a genetic pain disorder most often caused by gain-of-function variants in SCN9A encoding the Nav1.7 sodium channel and usually presents with bilateral, symmetric distal limb pain and redness. Here, we describe a multigenerational family with a strictly unilateral, trauma-triggered neurovascular pain phenotype associated with a previously unreported heterozygous germline SCN9A variant (c.4784T > G, p. Leu1595Arg). Affected individuals experienced episodic attacks in which minor mechanical or physiological stimuli induced progressive unilateral erythema, warmth, and severe pain spreading from the site of injury and sharply demarcated at the midline, without contralateral involvement. Attacks lasted hours to nearly one day and tended to decrease with age. The variant was absent from population databases and co-segregated with the phenotype within the family, fulfilling ACMG/AMP criteria for likely pathogenicity. The consistent unilateral distribution cannot be explained by mosaicism and is instead compatible with activation of ipsilateral segmental nociceptive and neurovascular reflex circuits that function largely independently across the spinal midline. We propose that excessive positive feedback between C-fiber activation and axon reflex-mediated neurogenic inflammation underlies attack propagation and duration. This framework also suggests therapeutic benefit from agents that interrupt activity-dependent transmitter release, such as gabapentinoids. These findings expand the phenotypic spectrum of SCN9A-related pain disorders and provide a genetically anchored model for unilateral RSD/CRPS-like neurovascular pain.

This review aims to evaluate the evidence regarding effectiveness of intravenous pamidronate in individuals with complex regional pain syndrome type I (CRPS I), focusing on pain reduction, functional outcomes, and dosing strategies. "PsycINFO, PubMed, EMBASE, SCOPUS, Web of Science, PEDro, and CINAHL" were searched until October 2025. The quality of the studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale for randomized controlled trials (RCTs), the ROBINS-I tool for non-randomized controlled trials (non-RCTs), and the Newcastle-Ottawa Scale for observational studies. Seven studies met the eligibility criteria. Two studies were of high quality, two had a high risk of bias, and three had a moderate risk of bias. The meta-analysis of three studies showed a non-significant effect size of 0.722 (Cohen's d, p = 0.381) with high heterogeneity (Q = 17.203, p < 0.001; I[2] = 88%) and a wide prediction interval (-19.257 to 20.701), highlighting high uncertainty and the need for cautious interpretation due to the limited studies. Intravenous pamidronate may offer symptom relief for individuals with CRPS I, particularly in reducing pain and edema and improving function. Given the heterogeneity of the studies and limited sample sizes, findings should be interpreted as preliminary and hypothesis-generating rather than definitive.

PURPOSE: To describe the epidemiology, injury mechanisms, diagnostic approach, management, and clinical outcomes of non-scaphoid carpal fractures, which are frequently overlooked or diagnosed late. METHODS: A retrospective review was conducted of patients with non-scaphoid carpal fractures treated at our institution between 2013 and 2020. Demographic data, fracture characteristics, time to diagnosis, treatment strategy, rehabilitation requirements, and clinical outcomes, including complications, were analyzed. RESULTS: 76 patients with 86 fractures were included; 54 (71%) were male. The most commonly affected bones were the triquetrum (37%) and hamate (33%). Isolated fractures accounted for 89% of cases. Advanced imaging was frequently required, with CT performed in 53% and MRI in 7% of patients. The median diagnostic delay was 6 days (range: 1–40). Conservative treatment was used in 84% of cases. Surgical management was significantly more frequent in lunate (75%) and hamate fractures (25%) (p = 0.008). Surgically treated patients required rehabilitation more often than those managed conservatively (58% vs. 31%, p = 0.012). Functional range of motion (> 40° flexion/extension) was achieved in 97% of patients. However, 16% developed chronic wrist pain, 8% reported prolonged soreness, and one patient developed reflex sympathetic dystrophy. CONCLUSIONS: Although functional outcomes are generally favorable, diagnostic delays remain common in non-scaphoid carpal fractures, particularly involving the lunate and capitate. Advanced imaging improves diagnostic accuracy but is often requested in complex or delayed cases, reflecting an indication bias. Early recognition and appropriate management are crucial to reduce persistent pain and complications.