Reply to: “Updated guidelines on complex regional pain syndrome in adults”

We read with interest the article by Dr. Henderson "Updated guidelines on complex regional pain syndrome in adults." 1 The article provides an elegant summary of the Royal College of Physicians (RCP) current guidelines in the diagnosis and treatment of complex regional pain syndrome (CRPS) and recommends surgical intervention for the treatment of Type 2 CRPS (i.e. CRPS with a recognized nerve injury). However, it fails to identify the timing of such interventions. This is important considering the emerging paradigm shift in concepts of nerve pain, specifically 'centralization' of pain in neuroma patients with delayed presentations.

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