Breaking the stigma : the association between psychological factors and the complex regional pain syndrome

Abstract

In 1900, Sudeck first described a post-traumatic pain syndrome with edema and trophic changes. This syndrome, known as Sudeck atrophy, was later called sympathetic reflex dystrophy and in 1994 renamed Complex Regional Pain Syndrome (CRPS). CRPS usually develops after a minor trauma such as an injury or fracture or after surgery, but spontaneous development of CRPS type 1 (CRPS1) has also been described. There are two types of CRPS described; CRPS1 arises without an obvious, detectable nerve lesion, and type 2 (CRPS2) manifests with an obvious, detectable lesion. The observation that only certain patients develop CRPS1 after a common trauma has led to the idea that some patients are susceptible to developing CRPS1. There are indications for a genetic susceptibility for CRPS129-33, and there is growing evidence for immunological attainment of this syndrome, but a definitive conclusion cannot yet be made. The International Association for the Study of Pain (IASP) defines CRPS1 as a variety of painful conditions following injury that appears regionally and has a distal predominance of abnormal findings