Introduction
Complex regional pain syndrome (CRPS) is a debilitating neuropathic disorder marked by persistent pain disproportionate to inciting injury (1, 2). Though CRPS is often seen in the setting of a traumatic event but may also occur spontaneously (3, 4). The pathophysiology of CRPS is likely multifactorial with many proposed mechanisms present in the literature involving dysregulation in both the sympathetic and central nervous systems, as well as contributions from genetic, inflammatory, and psychological factors (2).
CRPS pain is often accompanied by various other sensory, vasomotor, sudomotor, motor, or trophic symptoms (3). These symptoms significantly impact their quality of life and daily functioning (5). While reports of CRPS’ incidence range from 0.82 to 5.46 per 100,000 person-years (6, 7). the severe nature of CRPS underscores the need for effective treatment options.
Treatment for CRPS is often challenging, with many cases proving refractory to standard therapies (8). Conservative treatments typically include physical therapy, occupational therapy, or psychotherapy, along with medications such as NSAIDs, antiepileptic drugs (AEDs), antidepressants, and opioids (8). However, these medications often carry significant side effects and may not provide adequate relief for all patients. Invasive options, such as sympathetic blocks and spinal cord or dorsal root ganglion (DRG) stimulation (8), are available but bear risks associated with interventional procedures. As a result, there is a growing need for alternative approaches, particularly for patients who wish to avoid or have not benefited from conventional medications or interventional procedures.
Recent interest in the role of psychedelics in pain management has prompted exploration into their potential use for CRPS (9). This case report describes the experience of a 54-year-old female with CRPS and her use of psilocybin as a treatment. To our knowledge, this is the second case report suggesting the potential efficacy of psilocybin for managing CRPS symptoms.