Hi David,
Diagnosis of CRPS is usually made when everything else has been ruled out. There was a set of diagnosic guidelines drawn up a few years ago called the Budapest Criteria:
[quote]Clinical Diagnostic Criteria (the “Budapest Criteria”) for CRPS
General definition of the syndrome:
CRPS describes an array of painful conditions that are characterized by a continuing (spontaneous and/or evoked) regional pain that is seemingly disproportionate in time or degree to the usual course of any known trauma or other lesion. The pain is regional (not in a specific nerve territory or dermatome) and usually has a distal predominance of abnormal sensory, motor, sudomotor, vasomotor, and/or trophic findings. The syndrome shows variable progression over time.
To make the clinical diagnosis, the following criteria must be met:
1. Continuing pain, which is disproportionate to any inciting event
2. Must report at least one symptom in three of the four following categories:
Sensory: Reports of hyperesthesia and/or allodynia
Vasomotor: Reports of temperature asymmetry and/or skin color changes and/or skin color asymmetry
Sudomotor/Edema: Reports of edema and/or sweating changes and/or sweating asymmetry
Motor/Trophic: Reports of decreased range of motion and/or motor dysfunction (weakness, tremor, dystonia) and/or trophic changes (hair, nail, skin)
3. Must display at least one sign at time of evaluation in two or more of the following categories:
Sensory: Evidence of hyperalgesia (to pinprick) and/or allodynia (to light touch and/or temperature sensation and/or deep somatic pressure and/or joint movement)
Vasomotor: Evidence of temperature asymmetry (>1 °C) and/or skin color changes and/or asymmetry
Sudomotor/Edema: Evidence of edema and/or sweating changes and/or sweating asymmetry
Motor/Trophic: Evidence of decreased range of motion and/or motor dysfunction (weakness, tremor, dystonia) and/or trophic changes (hair, nail, skin)
4. There is no other diagnosis that better explains the signs and symptoms
For research purposes, diagnostic decision rule should be at least one symptom in all four symptom categories and at least one sign (observed at evaluation) in two or more sign categories.As far as staging goes... From chatting to various CRPS patients in the US it seems that some US doctors still refer to stages but out here it's changed, largely because a single person can have signs from all different stages. It's only real use i believe is in catching out people who present very early on.
Different treatments - other than meds. Sympathetic nerve blocks for an arm or leg. IV ketamine infusion (I know it's a med, but it's hardly a regular one). Physiotherapy is always important because a problem with crps is the the brain develops an unusual body representation. Which means you need to keep moving as normally as possible to stop that occurring. You might also want too look at graded motor imagery.
My story - the blog is a bit behaind, but perhaps have a look at
my site and at an interview my friend did -
CatalystHope that helps and as always if you've any questions :)
Laura
EDIT- thanks SB - both links are working now