Complex Regional Pain Syndrome Type I: Disease or Illness Construction?

Abstract

The phenomenon of complex regional pain syndrome type I (CRPS-I), once known as reflex sympathetic dystrophy (RSD), is not well understood. Clinicians are left feeling helpless and frustrated by the lack of effective treatment modalities when patients present with unexpected pain and disability. If this occurs after surgery, the event often strains the surgeon-patient relationship. Even patients who receive the most meticulous and well-executed surgical treatment are at some risk. For the most severe cases, when all else fails, some physicians consider amputation of the extremity to be an option. CRPS-I is diagnosed on the basis of nonspecific, subjective observations; lacks a consensus reference standard; and may prove to be an illness construction1 rather than an actual disease (think “whiplash”). …