Clinical features
The clinical symptoms of complex regional pain syndrome include:
- pain:
- allodynia or hyperalgesia
- out of proportion to the severity of the original injury
- frequently described as 'burning'
- progressive
- restlessness
- stiffness in affected joints
- altered hair growth
- skin colour changes, due to alterations in skin blood flow
- swollen limb
Clinical signs include evidence of abnormal sudomotor activity:
- warmth of limb
- excessive sweating
- stiffness
- oedematous limb, described as 'brawny'
- dry skin
- nail changes
Usually, the symptoms and signs are in the same limb as a preceding injury; sometimes they are in the distribution of just one peripheral nerve.
The diagnosis is made on the basis of pain, autonomic disturbance and functional impairment. However, other causes of pain and loss of function in the limb must be excluded first.
Reference
- Harden RN, McCabe CS, Goebel A, et al. Complex regional pain syndrome: practical diagnostic and treatment guidelines, 5th Edition. Pain Med. 2022 Jun 10;23(suppl. 1):S1-53.
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