Sex matters in complex regional pain syndrome

Abstract

Background Complex regional pain syndrome ( CRPS ) is much more prevalent in women than men but potential differences in clinical phenotype have not been thoroughly explored to date. Differences in the clinical presentation between sexes may point at new avenues for a more tailored management approach of CRPS . We therefore explored if in CRPS , the patient's sex is associated with differences in clinical and psychological characteristics. Methods In this cross‐sectional study of 698 CRPS patients (599 females) fulfilling the Budapest clinical or research criteria, CRPS signs and symptoms, CRPS severity, pain (average pain intensity in the previous week and McGill pain rating index), pain coping (Pain Coping Inventory), physical limitations (Radboud Skills Questionnaire (upper limb), Walking and Rising questionnaire (lower limb)), anxiety and depression (Hospital Anxiety and Depression scale) and kinesiophobia (Tampa scale for kinesiophobia) were evaluated. Results Male CRPS patients used more often extreme words to describe the affective qualities of pain, used more passive pain coping strategies, and were more likely to suffer from depression and kinesiophobia. Conclusion Sex‐related differences are present in CRPS , but the effect is generally small and mainly concerns psychological functioning. A greater awareness of sex‐specific factors in the management of CRPS may contribute to achieving better outcomes. Significance What is known? Nonsex‐specific clinical data of CRPS patients. What is new? Male CRPS patients used more often extreme words to describe the affective qualities of pain, used more passive pain coping strategies, and were more likely to suffer from depression and kinesiophobia.

Macrophages and Schwann cell TRPA1 mediate chronic allodynia in a mouse model of complex regional pain syndrome type I

“…Although a previous study detected a moderate difference in the development of mechanical allodynia in male and female mice (Tang et al, 2017), our research group previously reported (De Prá et al, 2019) and confirm in the current study, that there is no difference in non-evoked and evoked pain responses evoked by I/R in female vs. male mice. The absence of sex-related differences in the severity of pain in CRPS-I patients (Velzen et al, 2019) is in agreement with our mouse findings.…”

Disputing space-based biases in unilateral complex regional pain syndrome

“…This could be because we only included people who met more stringent Budapest research (compared to clinical) diagnostic criteria. The mean score on the Tampa Scale for Kinesiophobia indicated high pain-related fear of movement, comparable with previous CRPS research (Velzen et al, 2019). BPDS scores of participants with CRPS were significantly higher compared to controls, indicating significantly distorted perception of the CRPS-affected limb.…”

Complex Regional Pain Syndrome: A Comprehensive Review

“…Multiple studies have demonstrated CRPS to be much more prevalent in women, with estimates of 2–4 times the rate in men [ 1 , 3 , 10 – 12 , 18 ]. Van Velzen et al further investigated these sex-related differences, finding that male CRPS patients were more likely to suffer from depression and kinesiophobia, and use passive pain coping strategies [ 18 ]. Fibromyalgia is strongly and independently associated with a diagnosis of CRPS, increasing the risk up to 2.5 times that of controls [ 16 , 19 ].…”