What is CRPS?
Complex Regional Pain Syndrome (CRPS), also known as Reflex Sympathetic Dystrophy, is a chronic neurological
syndrome characterized by:
- severe burning pain
- pathological changes in bone and skin
- excessive sweating
- tissue swelling
- extreme sensitivity to touch
[For a complete description of CRPS symptoms, please
read the Diagnosis
section of the Clinical Practice Guidelines section of
this website.]
There are Two Types of CRPS - Type I and Type II
- CRPS Type I (also referred to as RSD) - cases in which
the nerve injury cannot be immediately identified
- CRPS Type II (also referred to as Causalgia) - cases in
which a distinct "major" nerve injury has occurred
- CRPS is best described in terms of an injury to a
nerve or soft tissue (e.g. broken bone) that does not follow
the normal healing path
- CRPS development does not appear to depend on the
magnitude of the injury. The sympathetic nervous system
seems to assume an abnormal function after an injury.
- Since there is no single laboratory test to diagnose CRPS,
the physician must assess and document both subjective complaints
(medical history) and, if present, objective findings (physical
examination).
Criteria for Diagnosing
Complex Regional Pain Syndrome Type I (RSD)
- The presence of an initiating noxious event, or a cause
of immobilization
- Continuing pain, allodynia, or hyperalgesia with which
the pain is disproportionate to any inciting event
- Evidence at some time of edema, changes in skin blood
flow (skin color changes, skin temperature changes more
than 1.1°C difference from the homologous body part), or
abnormal sudomotor activity in the region of the pain
- This diagnosis is excluded by the existence of conditions
that would otherwise account for the degree of pain and
dysfunction
Complex Regional Pain Syndrome Type II (Causalgia)
- The presence of continuing pain, allodynia, or hyperalgesia
after a nerve injury, not necessarily limited to the distribution
of the injured nerve
- Evidence at some time of edema, changes in skin blood
flow (skin color changes, skin temperature changes more
than 1.1°C difference from the homologous body part), or
abnormal sudomotor activity in the region of pain
- This diagnosis is excluded by the existence of conditions
that would otherwise account for the degree of pain and
dysfunction.
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