Complex regional pain syndrome - Diagnosis 

Diagnosing complex regional pain syndrome 

A thermographic image showing differences in skin temperature. Thermography is sometimes used to help diagnose CRPS. 

There is no single test for complex regional pain syndrome (CRPS). It is usually diagnosed by ruling out other conditions that have similar symptoms.

Tests

Possible tests used to rule out other conditions are:

Tests that give a good indication that you have developed CRPS (although they can't confirm it) are described below.

  • A physical examination, where your GP or another specialist will check for physical signs of CRPS, such as swollen joints and changes to your skin’s temperature and appearance.
  • Sweat testing, where the sweat produced by both your affected limb and an unaffected limb is measured. A large difference between the two readings could indicate CRPS.
  • Thermography, where an infrared thermometer is used to measure your skin temperature at different parts of your body. If your affected limb has a much higher, or lower, skin temperature than the rest of your body, it could indicate CRPS.
  • Electrodiagnostic testing, where wires are attached to your skin to measure the electrical activity of your nerves. Abnormal readings may suggest that your nerves are damaged, and that you have type two CRPS.

Diagnostic checklist

As CRPS can be difficult to diagnose, experts have created a checklist to assist GPs and other healthcare professionals when making a diagnosis.

A diagnosis of CRPS can be made if the following signs and symptoms are present:

  • You have recently experienced an injury or other type of trauma.
  • You have ongoing pain in a limb disproportionate to the original injury or trauma.
  • There is physical evidence of swelling, and changes to your skin temperature and appearance.
  • No other diagnosis would better explain your signs and symptoms.

Referral

If you are diagnosed with CRPS, you may be urgently referred to a specialist pain clinic. There are around 300 pain clinics in the UK, mostly within hospitals.

There is also a national centre for CRPS based at the Royal National Hospital for Rheumatic Diseases in Bath. You may be advised to visit the centre once your diagnosis is confirmed so that a treatment plan can be drawn up.

An urgent referral ensures treatment can be started immediately, because the earlier treatment is started, the less likely it is that you'll have any long-term disability.   




Page last reviewed: 23/05/2012

Next review due: 23/05/2014

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The 3 comments posted are personal views. Any information they give has not been checked and may not be accurate.

slebby3 said on 03 November 2013

I have been bedridden since april with crps,having to wait until end if this`month to see a specialist,I think the length if time I gave been left in agony is unforgivable,and I had to pay for a private gp to come out to diagnose me!!! My gp has`just left me to suffer.If an animal could not walk,it would be put out of its misery,I have this and 10 yrs`of severe domestic violence to contend with,escaped with police help last yr ans still no counselling!! Again unacceptable.Yours,ms`dudley.

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K Mac said on 08 July 2013

For over 8 years I painfully made my way to various GPs and I suspect they thought it was all in my mind. The original acute phase was"probably a sprain" of the ankle and I had an MRI of the right knee as it too was swollen and that came back as "house maid's knee". At no point was CRPS mentioned. Some years ago a diabetes clinician said "Oh that sounds like Fibromyalgia" . And that was it until I was diagnosed CRPS type 1 through a physical exam by a rheumy plus X ray and MRI.

Granted, CRPS is a difficult and rare disease to diagnose but in my experience it has been a mountain to climb to convince the medical profession that there was something catastrophic going on in my body. That mountain climbing has left me chronically exhausted.

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poco said on 21 January 2013

"If you are diagnosed with CRPS, you may be urgently referred to a specialist pain clinic"

But more realistically you will not be believed that anything is wrong with you, you will be stereotyped as a lazy person who is just trying to scam the system. You will be given the chepest possible medications if any at all. You will go years being ridiculed and losing all diginity for yourself. And the after finally being granted DLA, you may be lucky enough to get sent to some who can actually diagnoses you. Great you may think, but then you will realise that what you went threw is not special, and the majority of us suffering this have to go down this path. You will also then realise how ruined your life is, because you will find out that CRPS is incurable and largely untreatable. But the NHS will keep putting it on you as the fault, for only if you tried a little bit harder, the pain would go away.

This disease is one of the worst that there is, but how the NHS treats those with this disease is far worse. Bed bound for three days, and my doctor tells me he will not come out because I am not terminal.

If I had the strength to complain I would, but they know I do not.

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