When should I consider referring a patient with CRPS to a specialist for further management?

Consider referring a patient with complex regional pain syndrome (CRPS) to a specialist for further management if:

• They have severe pain or their pain significantly limits their lifestyle, daily activities (including sleep disturbance), and participation.
• There is deterioration in their underlying health condition related to CRPS.
• At any stage of their condition, including initial presentation and during regular clinical reviews, if the above criteria are met or if the pain is not effectively managed in primary care.

Referral to a specialist pain service and/or a condition-specific service is recommended to provide multidisciplinary management, including pharmacological and non-pharmacological treatments tailored to the patient’s needs.

This approach aligns with NICE guidance on neuropathic pain management and chronic primary pain, under which CRPS is classified.

NICE NG193,NICE CG173