Complex regionaal pijnsyndroom type 1?

Objective

To determine the final diagnosis in patients with a supposed complex regional pain syndrome type 1 (CRPS-1).

Design

Prospective descriptive study.

Method

All new patients referred to us in the period 2004-2007 with supposed CRPS-1 were assessed by our multidisciplinary CRPS team using the diagnostic criteria of Bruehl and the International Association for the Study of Pain (IASP). If CRPS-1 was excluded according to these criteria, the team in consensus made an alternative diagnosis when possible.

Results

During the research, 395 new patients were examined. CRPS-1 was excluded in 304 patients (77%). In 127 patients (32%) the pain syndrome was caused by an inadequate or unsuccessful treatment of their initial injury. In 26 patients (7%) no specific diagnosis was made. Eventually, 91 patients (23%) were diagnosed as having CRPS-1 according to the criteria of Bruehl and the IASP.

Conclusion

In the majority of patients with pain and autonomic disturbance of an extremity following injury or an operation, there is an underlying cause that should be treated before the diagnosis CRPS-1 can be made. Looking for underlying causes avoids doctor’s delay and ineffective treatments.