At present here are no scientific tests for Complex Regional Pain Syndrome (CRPS), a clinical diagnosis is based upon a set of guidelines. At in 2004, the International Association for the Study of Pain (IASP) set guidelines for the diagnosis of CRPS which superseded guidelines which had been in used for the decade previous.
The conference took place in Budapest so the new guidelines were named the Budapest Criteria.
Signs and Symptoms
The Budapest Criteria makes a distinction between signs, which are felt or seen the examining practitioner and symptoms which are reported by the patient but not evident to the practitioner.
Under the Budapest Criteria a patient must have at least one symptom in three of the following four categories in order to receive a diagnosis of Chronic Regional Pain Syndrome
1. Sensory: hyperaesthesia which is an abnormal increase in sensitivity and/or allodynia which is pain caused by stimuli that is usually non-painful;
2. Vasomotor: skin colour or temperature changes and/or skin colour differences between the limbs;
3. Sudomotor or oedema: oedema, which is swelling and/or perspiration changes and/or differentiation in perspiration between limbs.
4. Motor/trophic: motor dysfunction in the form of tremors, muscle spasms, weakness and decrease range or motor skills and/or changes to skin and/or hair and/or nails on the limb.
At the time of examination at least one sign must be present in two or more of the following categories:
1. Sensory: hyperalgesia and allodynia (hyper sensitivity) to normally non painful events, stimulus
2. Vasomotor: temperature differences and colour differences on the limb or between the limb and other limbs;
3. Sudomotor/oedema: perspiration changes or differences on the limb or between the limb and other limbs;
4. Motor/trophic: motor dysfunction such as tremor, muscle spasm or weakness and / or decreased range of motion function and/or trophic changes such as nail, skin or hair changes on the limb or between the limb and other limbs.
Finally, it is essential that there is no other clinical explanation for the symptoms and signs.
Frustratingly, whilst diagnosis is essential if the right treatment is to be prescribed, a common problem in diagnosing CRPS is that not all signs and symptoms are always present at the same time.
If CRPS is impacting you or someone you love and you want to find out how the counselling I provide can help you then please get in touch with me and we can look at how good therapy can make a huge difference in the lives of sufferers of this largely, as yet, unknown and under-researched condition.