How is complex regional pain syndrome diagnosed?

There is no individual test to establish the diagnosis of complex regional pain syndrome. In practice, the diagnosis depends on the combination of symptoms, physical examination findings, selective testing and the exclusion of other conditions.

Criteria for the diagnosis include the following:

• Chronic pain without clear explanation

• At least 3 of the following 4 reported symptoms –

o Excessive sensitivity or pain to stimulation that ordinarily doesn’t cause discomfort

o Abnormal temperature or skin color (such as one arm feeling cooler to the touch or appearing redder than the other)

o Swelling or changes in sweating in an extremity

o Reduced motion or function in an extremity and/or abnormal hair, skin or nails

• At least 2 of the following 4 examination findings –

o Excessive sensitivity to pinprick or excessive pain to light touch, temperature, pressure or movement

o Temperature or skin color difference between extremities

o Swelling or abnormal sweating

o Decreased range of motion or function or changes in skin, nail or hair

Testing may include x-rays, a bone scan and measures of skin temperature.