Complex regional pain syndrome — 1: history, diagnostic criteria and etiology

Abstract

Abstract Physical therapists and other health care providers frequently evaluate and treat patients with complex regional pain syndrome (CRPS). The term CRPS replaces the previous terms reflex sympathetic dystrophy (now referred to as CRPS Type I) and causalgia (CRPS Type II). Part 1 of this paper describes the diagnostic criteria for CRPS and the clinical features and etiology of both CRPS Types I and II. CRPS is a multifactorial syndrome with overlapping symptoms. Although much progress has been made in the understanding of CRPS, many questions remain unanswered. CRPS is probably a disease of the central nervous system. Yet, peripheral inflammatory processes, abnormal sympathetic-afferent coupling, and adrenoreceptor pathology may also be part of the picture. It is likely that in the near future the current concepts of CRPS will be replaced by a new mechanism-based term or group of terms leading to improved clinical guidelines. Part 2 in this series reviews the physical therapy management of patients with CRPS.