How is CRPS Complex Regional Pain Syndrome diagnosed?

See how CRPS Complex Regional Pain Syndrome is diagnosed. Which specialists are essential to meet, what tests are needed and other useful information for the diagnosis of CRPS Complex Regional Pain Syndrome

CRPS Complex Regional Pain Syndrome diagnosis

Diagnosing CRPS (Complex Regional Pain Syndrome)

Complex Regional Pain Syndrome (CRPS) is a chronic pain condition that typically affects one limb, often after an injury or trauma. It is characterized by intense and disproportionate pain, changes in skin color and temperature, swelling, and limited range of motion. Diagnosing CRPS can be challenging as there is no specific test or imaging study that can definitively confirm its presence. Instead, healthcare professionals rely on a combination of clinical evaluation, medical history, and diagnostic tests to make an accurate diagnosis.

Clinical Evaluation

The first step in diagnosing CRPS involves a thorough clinical evaluation by a healthcare professional, typically a pain specialist or neurologist. They will review the patient's medical history, including any previous injuries or trauma, and conduct a physical examination. During the examination, the healthcare professional will assess the patient's pain levels, skin color and temperature changes, swelling, and any changes in hair or nail growth. They will also evaluate the patient's range of motion and sensitivity to touch.

Key clinical features that may indicate CRPS include:

Continuous, intense, and disproportionate pain

Changes in skin color and temperature (e.g., redness, coolness)

Swelling and stiffness in the affected limb

Abnormal hair or nail growth

Changes in skin texture (e.g., shiny, thin)

Increased sensitivity to touch or cold

Medical History

A detailed medical history is crucial in diagnosing CRPS. The healthcare professional will ask the patient about their symptoms, the onset and progression of pain, and any previous injuries or trauma to the affected limb. They will also inquire about any underlying medical conditions, such as nerve damage, arthritis, or autoimmune disorders, as these can increase the risk of developing CRPS.

Important factors in the medical history that may contribute to a CRPS diagnosis include:

Previous injuries or trauma to the affected limb

Underlying medical conditions (e.g., nerve damage, arthritis)

Surgeries or medical procedures

Family history of CRPS or chronic pain conditions

Diagnostic Tests

While there is no specific test for CRPS, diagnostic tests may be used to support the diagnosis and rule out other conditions with similar symptoms. These tests help healthcare professionals gather objective evidence to confirm the presence of CRPS.

Common diagnostic tests for CRPS include:

X-rays: X-rays can help identify any bone abnormalities or fractures that may be contributing to the symptoms.

Bone scans: A bone scan involves injecting a small amount of radioactive material into the bloodstream, which is then absorbed by the bones. Areas of increased bone activity may indicate CRPS.

Magnetic Resonance Imaging (MRI): An MRI scan can provide detailed images of the affected limb, helping to rule out other conditions and identify any soft tissue abnormalities.

Sympathetic Nervous System Tests: These tests evaluate the function of the sympathetic nervous system, which is often affected in CRPS. They may include thermography (measuring skin temperature), sweat tests, or nerve conduction studies.

It is important to note that while these tests can provide supportive evidence, they are not definitive for diagnosing CRPS. The diagnosis is primarily based on the clinical evaluation and medical history.

Seeking a Specialist

Due to the complexity of CRPS diagnosis, it is recommended to seek the expertise of a pain specialist or neurologist who has experience in managing chronic pain conditions. These specialists are familiar with the diagnostic criteria and can provide a comprehensive evaluation to determine if CRPS is present.

Early diagnosis and intervention are crucial for managing CRPS effectively. If you suspect you may have CRPS or are experiencing persistent and severe pain after an injury or trauma, it is important to consult with a healthcare professional for an accurate diagnosis and appropriate treatment.

Diseasemaps

Well it's diagnosed based on what you tell the doctor. With me I had a broken growth plate, but I was told for 8 months it was a sprain. After that I saw someone else and he said it was CRPS so usually it just takes a while.

Posted Apr 20, 2017 by Chloe 1000

There is no good way to diagnose CRPS. The tests they give can often be painful and don't tell the whole story. The best physician to see is an Anesthesiologist or Neurologist. I had two nerve conduction studies performed that where very, very painful that showed I was having slowing and abnormal nerve speeds. I would not wish this test upon anyone who has CRPS. Bone Scan is another test that can be done. Other times X-rays can show CRPS related bone loss.

Honestly, the best test is temperature tests from one limb to the other. Anything over 1/2 °C change along with a history of other symptoms is a good indicator. For example my affected foot was 5 °C colder than my other foot. that's almost 10° F difference. Very painful.

Posted May 9, 2017 by Jon 1100

There is no definitive diagnostic test to confirm crps. It is diagnosed by inproportionate pain levels compared to the initial injury, if there was one. Also it is diagnosed by elimination of other diseases that match the symptoms till all options are eliminated. It is a hard diagnosis to get to and many still suffer with crps but have been misdiagnosed as it is a very complex disease, hence the name complex regional pain syndrome. The best thing to do to get to a diagnosis is be persistent in your care and in the search for answers, even if you end up seeing several doctors. If you think you may have crps, look for a doctor that specializes in crps.

Posted May 24, 2017 by Vicki 500

By a pain management doctor that is familiar with the disease

Posted May 24, 2017 by Stevi 600

Before being diagnosed, I went through the process of elimination for everything else: nerve conduction study, bone scan, rheumatology tests, PT, OT, you name it. There are no tests "for" CRPS. It really just comes after you've eliminated all other possibilities

Posted May 28, 2017 by Amy 500

CRPS is extremely difficult to diagnose. You really have to test for everything else until you're left with CRPS

Posted Aug 17, 2017 by Chelsea 2335

Often sets in after surgery. There are neurological tests that can be carried out but are not specific and CRPS has no set test. Any pain that continues for longer than 6 months is chronic

Posted Sep 6, 2017 by [email protected] 5060

For me it was mostly the symptoms I had. But also had EMG, therm-graph, bone density.

Posted Sep 11, 2017 by Craig 1600

For me diagnosis was very slow as it can only really be diagnosed by eliminating every other possibility. Yes there is pain, swelling, color, lack of mobility and sensation too but various things can produce some or all of the above.

Posted Sep 13, 2017 by Andy 3550

CRPS is one of those diseases that depends on ruling out other conditions and then meeting certain criteria before a diagnosis is given. Most pain management doctors utilize the Budapest criteria for diagnosing CRPS:

1. Continuing pain, which is disproportionate to any inciting event
2. Must report at least one symptom in three of the four following categories:
A. Sensory: reports of hyperesthesia and/or allodynia
B. Vasomotor: reports of temperature asymmetry and/or skin color changes and/or skin color asymmetry
C. Sudomotor/edema: reports of edema and/or sweating changes 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, nail, 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 color changes and/or asymmetry
C. Sudomotor/edema: evidence of edema 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, nail, skin)
4. There is no other diagnosis that better explains the signs and symptoms

Posted Sep 15, 2017 by DrLisa 3750

Pain specialist and neurologists

Posted Sep 19, 2017 by Alex 2550

This is the most difficult part of this disease. There is no test that states you have CRPS. It is diagnosed normally after an injury that doesn't heal. It can take a long time to diagnos for this reason and if diagnosed sooner a person could actually go into remission. Individuals that have an injury that should have healed and hasn't should consult with a pain clinic immediately. Most now are aware of this disease. Many neurologists are also.

Posted Oct 8, 2017 by Valerie 1500

Your doctor will diagnose it. It can be diagnosed by looking and listening to your symptoms. There is no diagnostic test that can diagnose crps Type 1 or 2. There are tests to confirm nerve damage for Type 2

Posted Nov 11, 2017 by Robbie 2000

Bone scans are helpful, I was seen by pain management doctors for evaluation by my PCP and was diagnosed after she looked . EMGs are often suggested , often times not performed due to the possibly of CRPS and the dangers of spreading. X-rays don’t show the disease . A neurologist is a great teammate, pain management doctor, physical therapist is key.

Posted Nov 11, 2017 by Aj 2000

Through a medical history and ruling out tests. MRI and an EGG.

Posted Nov 12, 2017 by Shanna 5000

I believe it is diagnosed based on symptoms. I would suggest that a patient see a doctor who specializes in CRPS, a pain management doctor and a physical therapist.
For diagnosis the doctor needs to have a complete history of the patient and their injury as well as their symptoms.

Posted Nov 12, 2017 by ladyff1481 2050

In my case, I saw a neurologist, rheumatologist, and six orthopedic surgeons. It was the orthopedic surgeons who asked the right questions and who were the most observant as they specialize in joints. My injury started after a violent hit to my right elbow.
So, see an orthopedic surgeon if you don't want to waste time. But ask to see a neurologist for an EMG to determine type 1 or 2. Mine is type 2 -- nerve damage indicated.

Posted Nov 13, 2017 by Thea 3150

The Budapest criteria, interdisciplinary work, multimodal pain therapy, pain therapist, neurologist, orthopedic, QST

Posted May 30, 2018 by Passwort123 700

Temperature of skin, color of infected area, swelling and sensitivity.

Posted May 31, 2018 by Marcia 500

By using the Buda Pest Criteria ie, Signs that are visible.

Posted Oct 25, 2018 by Misty 2100

In the case of a fracture, I believe the Orthopedist should be able to diagnose it. When the symptoms are severe (like mine), they should be capable to recognize the telltale signs. Abnormal swelling, purple/blue claw like hand shape, horrific pain, lack of mobility beyond fracture site, etc. The sooner the diagnosis the better. Then on to nerve blocks. I saw a Neurologist, Rheumatologist, Physiologist etc....

Posted Nov 1, 2018 by Judy 3000

Usually, a Neurologist will diagnose the CRPS by depending on the location of CRPS some have Ganglion Blocks done along with MRIs and EMG test. To make sure it is not some other disease that is simular.

Posted Jan 5, 2019 by Cynthia 4000

Nerve conduction tests
Nerve blocks (injection)
Sometime blood work

All is to rule out anything else mainly

Posted Jan 16, 2021 by Patricia 3050

You need to get and MRI and X-Ray done to rule out any breaks or fractures. Then you need to see a neurologist. After your diagnoses, you may need to see a pain specialist or physical therapist to seek additional care.

Posted Mar 29, 2021 by Sage0920 2000

Exclusionary tests tor rule out others such as Multiple Scleroris, Fibromyalgia et al.

Posted Nov 3, 2022 by Heather 5020