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Painful arthroplasty with disproportionate pain: Recognition and management of complex regional pain syndrome
Stephanie O’Palko, Alexander Burbelo, Andrew Murphy, Matthew Bullock, Department of Orthopaedic Surgery, Marshall University, Joan C Edwards School of Medicine, Huntington, WV 25701, United States
Author contributions: O’Palko S and Burbelo A were responsible for writing the original draft of the manuscript; Murphy A and Bullock M were responsible for editing the manuscript. All authors read and approved the final manuscript.
AI contribution statement: No artificial intelligence tools were used in the preparation of this manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Alexander Burbelo, BS, Research Fellow, Department of Orthopaedic Surgery, Marshall University, Joan C Edwards School of Medicine, 1600 Medical Center Drive - Suite G500, Huntington, WV 25701, United States. burbelo@marshall.edu
Received: August 10, 2026
Revised: August 30, 2026
Accepted: October 12, 2026
Published online: October 18, 2026
Processing time: 69 Days and 12.7 Hours
Revised: August 30, 2026
Accepted: October 12, 2026
Published online: October 18, 2026
Processing time: 69 Days and 12.7 Hours
Core Tip
Core Tip: Complex regional pain syndrome is an underrecognized cause of persistent pain after total hip and knee arthroplasty, with features that overlap with normal recovery, infection, and mechanical complications. This review provides a systematic diagnostic approach and clarifies that sympathetic nerve blocks offer only limited, temporary benefit.