Complex Regional Pain Syndromes (CRPS)

Complex Regional Pain Syndromes (CRPS)

The task force identified the problem that the term “reflex sympathetic dystrophy” was often used in cases that did not have sympathetically maintained pain, or a dystrophic component.

CRPS TYPE I: Reflex Sympathetic Dystrophy

“CRPS Type I is a syndrome that usually develops after an initiating noxious event, is not limited to the distribution of a single peripheral nerve, and is apparently disproportionate to the inciting event. It is associated at some point with evidence of edema, changes in skin blood flow, abnormal sudomotor activity, in the region of pain, or allodynia or hyperalgesia.”

Diagnostic Criteria:
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, 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.

Criteria 2, 3, and 4 must be satisfied.

CRPS TYPE II: Causalgia

“Burning pain, allodynia, and hyperpathia usually in the hand or foot after partial injury of a nerve or one of its major branches.”

Diagnostic Criteria
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, 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.

All three criteria must be satisfied.