Complex Regional Pain Syndrome

Complex Regional Pain Syndrome (CRPS) is a chronic pain condition, which has been recognised since it was first described by an American neurologist Dr Mitchel in injured soldiers during the American Civil War. Dr Mitchel astutely suggested that the condition was due to irritation or damage of nerves that he could not see. He described the condition as "Causalgia" a word derived from "kausticos" Greek for "able to burn". Since its first description CRPS as it is now known, has been described as Sudeks Atrophy, Reflex Sympathetic Dystrophy (RSD), Shoulder-Hand syndrome, Algodystrophy, Neuroalgodystrophy, Reflex Neurovascular Dystrophy and Sympathetically Maintained Pain.

1. Follows an initiating noxious event.
2. Spontaneous pain and/ or allodynia and hyperalgaesia occur beyond the territory of single peripheral nerve(s), and is disproportionate to the inciting event.
3. There is or has been evidence of oedema, skin blood flow abnormality, or abnormal sudomotor activity, in the region of the pain since the inciting event.
4. The diagnosis is excluded by the existence of conditions that would otherwise account for the degree of pain or dysfunction.

1. Is a more regionally confined presentation about a joint or area, associated with a noxious event.
2. Spontaneous pain and/ or allodynia and hyperalgaesia are usually limited to the area involved but may spread variably distal or proximal to the area, not in the territory of a dermatomal or peripheral nerve distribution.
3. Intermittent and variable oedema, skin blood flow change, temperature change, abnormal sudomotor activity, and motor dysfunction, disproportionate to the inciting event are present in the area involved.