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Complex regional pain syndrome F092

Last amended 
7 November 2016
Current RMA Instruments
Reasonable Hypothesis SOP
97 of 2016
Balance of Probabilities SOP
98 of 2016
SOP bulletin information on new Instruments

SOP bulletin 193

ICD Coding
  • ICD-9-CM Codes: 337.2, 354.4, 355.71
  • ICD-10-AM Codes: G56.4, G57.7, G90.5
Brief description

Complex regional pain syndrome (CRPS) is a disorder of a body region, usually a limb, characterised by excessive, disproportionate pain, variable skin changes (involving sensation, temperature, colour, swelling, trophic changes), decreased joint motion, and patchy bone demineralization. It covers a group of conditions formerly known under a variety of names, including reflex sympathetic dystrophy, causalgia and Sudeck atrophy.

Confirming the diagnosis

The condition is poorly understood and diagnosis may be difficult and is often delayed.  The diagnosis is made clinically, with the criteria specified in the SOP needing to be fulfilled (including the need for objective signs of the condition).

The relevant medical specialist is a pain specialist (anaesthetist) or neurologist.  The patient may have presented to an orthopaedic surgeon, rheumatologist or dermatologist in the course of investigation of the condition.

Additional diagnoses covered by the SOP
  • algodystrophy
  • causalgia
  • reflex sympathetic dystrophy
  • Sudeck atrophy
Conditions not covered by the SOP
  • "Chronic pain syndrome" - imprecise diagnosis - seek clarification if possible.
Clinical onset

Clinical onset will be when the diagnostic criteria are first fulfilled, which will generally be within four to six weeks of an inciting event such as a fracture or surgery.  The initial symptoms usually include pain, erythema, and swelling, with pain most prominent. 

Clinical worsening

The only worsening factor is for inability to obtain appropriate clincial management. The condition can spread to other limbs if undiagnosed and untreated.  There is no cure for the condition but it resolves over time in most patients.  Pain flares are common and not a sign that the condition is worsening.