Complex regional pain syndrome: From diagnosis to rehabilitation

Table 1 Orlando (International Association for the Study of Pain) criteria for complex regional pain syndrome

Criteria 1	The presence of an initiating noxious event or a cause of immobilisation
Criteria 2	Continuing pain, allodynia, or hyperalgesia with which the pain is disproportionate to any inciting event
Criteria 3	Evidence at some time of oedema, changes in skin blood flow, or abnormal sudomotor activity in the region of pain (can be sign or symptom)
Criteria 4	This diagnosis is excluded by the existence of other conditions that would otherwise account for the degree of pain and dysfunction

Table adapted from Merksey et al[158].

Table 2 Budapest clinical diagnostic criteria for complex regional pain syndrome

Criteria 1	Continuing pain, which is disproportionate to any inciting event
Criteria 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 colour changes and/or skin colour asymmetry
	Sudomotor/oedema: reports of oedema 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)
Criteria 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 deep somatic pressure and/or joint movement) Vasomotor: evidence of temperature asymmetry and/or skin colour changes and/or asymmetry Sudomotor/oedema: evidence of oedema 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)
Criteria 4	There is no other diagnostic that better explains the signs and symptoms

Table adapted from Harden et al[18].