Complex regional pain syndrome type 1 may be associated with menstrual cycle disorders: A case-control study

Background: Complex regional pain syndrome type 1 (CRPS1) can develop after severe trauma or surgery in the limbs, and presents with chronic, changes in temperature, edema and dysfunction. Seventy-five percent of CRPS1 patients are female. While neurological and inflammatory components have been proposed, the etiology remains unclear. No consensus on optimal management of CRPS1 exists. In traditional Chinese medicine, menstrual disorders are related to the state of women constitution and therefore identify their pain patterns. A classification by constitution might improve the pain management in CRPS1 patients. It is unknown whether associations exist between menstrual-cycle-conditions and CRPS1. Aim: To investigate whether a specified menstrual condition is associated with the risk of developing CRPS1. Methods: A population-based case-control study of CRPS1 was conducted among Dutch women aged 18-82; i.e. 34 women with CRPS1 and 147 controls. A standard questionnaire consisting of 59 menstrual-cycle-symptom-based questions was administered. From this questionnaire, 15 CRPS1-retated questions (DRQ 15) were analyzed. We used muttivariate logistic regression to obtain odds ratios and 95% confidence intervals (CI) for specified menstrual disorders adjusting for age, oral contraceptives, hysterectomy and age at menarche <= 12 and >= 17 years. Results: On the basis of the DRQ 15, women with CRPS1 were 5.3 (95%CI 2.1, 12.9) times more Likely to have menstrual disorders than comparable controls. Conclusion: Our results suggest that selected menstrual conditions are associated with the risk of developing CRPS1. (C) 2009 Elsevier Ltd. All rights reserved.