Global Burden of Complex Regional Pain Syndrome in At-Risk Populations: Estimates of Prevalence From 35 Countries Between 1993 and 2023.

Summary

Across 214 studies from 35 countries (n≈2.49 million), pooled CRPS prevalence after inciting events was 3.04% at 12 months and 6.46% at 24 months. Prevalence was higher after traumatic versus surgical inciting injuries, in higher-HDI settings, and in prospective versus retrospective designs; more recent studies reported lower 12-month prevalence.

Key Findings

• Pooled global CRPS prevalence among at-risk individuals was 3.04% at 12 months and 6.46% at 24 months.
• Higher prevalence was observed after traumatic inciting injuries versus surgical injuries, and in higher-HDI countries.
• Prospective studies reported higher prevalence than retrospective studies; publication year moderated prevalence (recent studies reported lower 12-month prevalence).

Clinical Implications

Clinicians should counsel high-risk patients (especially post-trauma) that CRPS risk approaches 3–6% within 1–2 years, and implement early detection/prevention protocols. Programs can target modifiable factors and allocate follow-up resources where risk is highest.

Limitations

• Heterogeneity across studies and diagnostic ascertainment differences likely influence pooled estimates.
• Prevalence differences by design (prospective vs retrospective) suggest potential measurement and selection biases.

Future Directions

Standardize diagnostic criteria and prospective surveillance in high-risk surgical and trauma cohorts to refine risk prediction and test targeted prevention strategies.