Complex Regional Pain Syndrome (CRPS) of the Hand or Wrist

Understanding CRPS after fracture or surgery

Complex regional pain syndrome (CRPS) can occur after trauma, fracture, immobilization or surgery. It is not a complication that can be predicted with certainty, but early recognition is helpful.

This page helps you understand the symptoms that may alert, how the diagnosis is made, and what management options are available at the European Institute for Hand Surgery.

Symptoms That May Alert

CRPS manifests through a set of symptoms that may vary from patient to patient. These signs do not automatically mean it is CRPS, but they warrant clinical evaluation.

Unusual or Disproportionate Pain

Pain that seems excessive relative to the initial injury or persists beyond the expected period.

Hypersensitivity to Touch, Cold or Contact

The hand becomes painful with the slightest contact, even light, or with temperature changes.

Persistent Swelling

Edema that does not decrease despite elevation and adherence to usual instructions.

Stiffness and Difficulty Resuming Movement

Mobility limitation that sets in or worsens despite rehabilitation.

Temperature, Color or Skin Appearance Changes

The hand may be warmer or colder, red or pale, with shiny or dry skin.

Modified Sweating or Foreign Hand Sensation

Excessive sweating or very dry skin, feeling that the hand no longer responds normally.

Important: These signs do not automatically mean it is CRPS. They warrant clinical evaluation to establish the diagnosis and exclude other possible causes.

How the Diagnosis Is Made

The diagnosis of CRPS is clinical, based on the patient's history, physical examination and exclusion of other possible causes such as infection, healing problems, nerve compression or mechanical complications.

Medical Interview

The surgeon gathers the history of your trauma or surgery, symptom progression and their impact on daily life.

Clinical Examination

Assessment of pain, sensitivity, mobility, skin appearance, temperature and swelling.

Exclusion of Other Causes

X-rays or other tests may be requested to rule out infection, healing problem, compression or other complication.

No single test is sufficient to confirm CRPS diagnosis. It is the combination of clinical history, examination and exclusion of other causes that allows the diagnosis.

How Is CRPS Treated?

CRPS management is based on an early and personalized approach, adapted to each patient and symptom progression.

Pain Control

Adjustment of pain medication to allow mobilization and rehabilitation in the best possible conditions.

Gradual Mobilization and Rehabilitation

Progressive work with a specialized hand therapist to recover mobility and function without worsening symptoms.

Progressive Resumption of Hand Use

Adaptation of daily gestures and gradual resumption of activities according to care team advice.

Multidisciplinary Coordination

Collaboration with general practitioner, pain specialist or other professionals if necessary.

When to Consult Promptly?

Contact the care team if you notice:

  • Pain increases, becomes unusual or prevents sleep or hand mobilization despite prescribed measures
  • Swelling, stiffness or skin changes set in or worsen
  • Hypersensitivity to touch or cold appears or intensifies

Need Specialized Advice?

The European Institute for Hand Surgery team is available to assess your situation