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Complex Regional Pain Syndrome (CRPS) is a problem
that is receiving more attention in the personal injury
field. As the name implies, it is a complex injury and
one that has provoked considerable debate.
If you have suffered an injury of this nature or whiplash in an accident within the last three years,
you may be entitled to claim compensation for your pain
and suffering. CRPS claims CRPS is, as the name implies,
a syndrome. This is a collection of symptoms (what the
patient reports) and signs (what the doctor finds on
examination), but behind which there is not a clearly
unified pathological process. It is usually precipitated
by comparatively minor trauma (in most instances), and
frequently immobilisation .
Along with the pain is the development of a variety
of changes which would often be associated with
abnormalities of the sympathetic nervous system (hence
the former diagnosis of reflex sympathetic dystrophy),
namely changes in the blood supply, giving rise to
alterations in the colour and temperature of the limb,
changes in sweating, changes in appearance of the limb
which becomes swollen, shiny and hairless. Finally
there are changes to the muscles, in particular muscle
wasting.
The modified clinical diagnostic criteria for CRPS
are:
1) Continuing pain which is disproportionate to the
inciting event
2) Must report at least one symptom in three of the
four following categories (a) Sensory: Reports of
hyperaesthesia and/or allodynia (b) Vasomotor: Reports
of temperature asymmetry and/or skin colour changes
and/or skin colour asymmetry (c) Sudomotor/oedema:
Reports of oedema and/or sweating asymmetry (d) Motor/Trophic:
Reports of decreased range of motion and/or motor
dysfunction (weakness, tremor, dystonia) and/or trophic
changes (hair, nails, skin)
3) Must display at least one sign at time of
evaluation in two or more of the following categories:
(a) Sensory: Evidence of hyperalgesia (to pinprick)
and/or allodynia (to light touch and/or deep somatic
pressure and/or joint movement). (b) Vasomotor: Evidence
of temperature asymmetry and/or skin colour changes (c)
Sudomotor/oedema: Evidence of oedema and/or sweating
changes and/or sweating asymmetry. (d) Motor/Trophic:
Evidence of decreased range of motion and/or motor
dysfunction (weakness, tremor, dystonia) and/or trophic
changes (hair, skin, nails)
4) There is no other diagnosis that better explains
the signs and symptoms” (p55)
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