Complex regional pain syndrome F092

Current RMA Instruments

Changes from previous Instruments

ICD Coding

• ICD-10-AM Codes: G56.4, G57.7, G90.5

Brief description

Complex regional pain syndrome (CRPS) is a disorder affecting a body region, characterised by continuing pain that is disproportionate to any inciting event, together with sensory, vasomotor, sudomotor/oedema, or motor/trophic abnormalities.

Symptoms and signs may include hyperesthesia or allodynia, temperature change or skin colour asymmetry, oedema or sweating abnormalities, decreased range of motion, motor dysfunction or trophic changes involving the skin, hair or nails. The condition may affect one or more limbs and may occur following trauma, fracture, surgery or other inciting events.

Confirming the diagnosis

The diagnosis is made clinically and requires fulfilment of the diagnostic criteria specified in the SOP. The diagnosis requires:

• continuing pain disproportionate to any inciting event
• symptoms in at least three of the four specified diagnostic categories AND
• objective clinical signs in at least two of the four specified diagnostic categories at the time of evaluation

Clinical assessment may include evaluation of sensory abnormalities, vasomotor changes, oedema or sweating abnormalities, motor dysfunction and trophic changes.

Management and confirmation are usually undertaken by a pain specialist or neurologist.

Additional diagnoses covered by the SOP

• Algodystrophy
• Causalgia
• Complex Regional Pain Syndrome
• Reflex sympathetic dystrophy
• Sudeck atrophy

Conditions not covered by the SOP

• 'Chronic pain syndrome' - imprecise diagnosis, seek clarification
• 'Pain disorders' not fulfilling the CRPS diagnostic criteria 

Clinical onset

Clinical onset generally corresponds to the time when the diagnostic criteria for CRPS are first fulfilled and confirmed by a Pain Specialist. Symptoms commonly develop following an inciting event such as trauma, fracture or surgery, and may initially include pain, swelling, erythema or reduced limb function.

Clinical worsening

Clinical worsening may be indicated by increasing pain, progression of sensory, vasomotor, sudomotor or motor/trophic abnormalities, worsening functional impairment, or spread of symptoms to additional body regions. Specialist advice should be sought when assessing for possible clinical worsening and progression beyond the normal clinical course. Adverse outcomes may occur where there is inability to obtain timely and appropriate clinical management.