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Reflex sympathetic dystrophy: changing concepts and taxonomy

M Stanton-Hicks1, W Jänig, S Hassenbusch

  • 1Pain Management Center, Cleveland Clinic Foundation, Cleveland, OH 44195 USA Physiologisches Institut, 2300 Kiel, Germany Department of Neurosurgery, M.D. Anderson Cancer Center, Houston, TX 77030 USA Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905 USA Section of Anaesthesia, University of Auckland, School of Medicine, Auckland, New Zealand Pain Management Center, Emory Clinic, Atlanta, GA 30322 USA.

Pain
|October 1, 1995
PubMed
Summary
This summary is machine-generated.

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A new classification system, Complex Regional Pain Syndrome (CRPS), unifies reflex sympathetic dystrophy and causalgia. CRPS requires regional pain and sensory changes following injury, with specific clinical signs exceeding expected severity.

Area of Science:

  • Pain Medicine
  • Neurology
  • Clinical Taxonomy

Background:

  • Reflex sympathetic dystrophy (RSD) and causalgia are debilitating chronic pain conditions with overlapping symptoms.
  • Previous classifications lacked a unified diagnostic framework, hindering consistent diagnosis and treatment.
  • A consensus conference was convened to revise the taxonomic system for these disorders.

Framework:

  • Introduced Complex Regional Pain Syndrome (CRPS) as an umbrella term for RSD and causalgia.
  • CRPS diagnosis requires regional pain and sensory changes post-noxious event.
  • Key diagnostic criteria include specific clinical signs (e.g., altered skin color, temperature, edema) disproportionate to the inciting injury.

Implementation:

  • CRPS is categorized into two types: Type I (formerly RSD, no definable nerve lesion) and Type II (formerly causalgia, with a definable nerve lesion).

Related Experiment Videos

  • The term sympathetically maintained pain (SMP) was evaluated and deemed a variable phenomenon, not a distinct category.
  • These revised classifications are incorporated into the 2nd edition of the IASP Classification of Chronic Pain Syndromes.

    • Implications:

    • Provides a standardized, evidence-based diagnostic framework for CRPS.
    • Facilitates improved communication, research, and clinical management of CRPS patients.
    • Enhances understanding of the pathophysiology and clinical presentation of these complex pain disorders.