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Abstract
A sidebar titled “Rating Impairment for [complex regional pain syndrome] CRPS Type 1” in the March/April issue of The Guides Newsletter states: “Do NOT use the pain chapter to rate CRPS” because there is no well-defined pathophysiologic basis. That conclusion is contradicted by the pain chapter, which lists CRPS among conditions considered ratable, but accompanying text provides no explanation how this determination was made. This article attempts to resolve the conflict between the sidebar in The Guides Newsletter and the pain chapter. The lack of a well-defined pathophysiologic basis for CRPS is the reason for the position stated in the sidebar, and a review of the relevant professional literature confirms this reasoning. Further, the concept of CRPS itself is ambiguous and was intentionally designed to be “general” and “descriptive” and historically has been diagnosed using nonstandardized, idiosyncratic, or incompatible diagnostic systems. The AMA Guides to the Evaluation of Permanent Impairment is self-contradictory regarding diagnostic criteria and terminology (eg, is CRPS-1 synonymous with RSD, causalgia, or neither?). CRPS lacks any well-defined pathophysiology, is highly ambiguous and controversial, involves characteristics that compromise the credibility of any examinee making such a presentation, and is a good example of a condition that should be evaluated using the mental and behavioral disorders chapter.
- Abstract
- Criteria for Ratability Through the Pain Chapter
- Does CRPS Have a Well-Defined Pathophysiologic Basis?
- Is the Concept of CRPS Ambiguous?
- Is the Concept of CRPS Controversial?
- Can CRPS-like Presentations Be Adequately Rated Through Any Other Chapters?
- Credibility of the Examinee
- Contrasting the Above Considerations With the Pain Chapter's Conclusion CRPS Might Be Ratable
- Summary
- References
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1.
Rating Impairment for CRPS Type 1. The Guides Newsletter. March-April 2006: 10.
-
2.
Cocchiarella L, Anderson G (eds). Guides to the Evaluation of Permanent Impairment, Fifth Edition. Chicago, Ill: American Medical Association; 2001.
-
3.
Cocchiarella L, Lord SJ. Master the AMA Guides Fifth. Chicago, Ill: American Medical Association; 2001.
-
4.
Demeter SL, Andersson GBJ. Disability Evaluation, 2nd ed. Chicago, Ill: Mosby/American Medical Association; 2003.
-
5.
Loeser JD. Bonica's Management of Pain. 3rd ed. Philadelphia, Pa: Lippincott, Williams, and Wilkins; 2001.
-
6.
Mersky H, Bogduk N. Classification of Chronic Pain. 2nd ed. Seattle, Wash: International Association for the Study of Pain Press; 1994.
-
7.
Wilson PR, Stanton-Hicks M, Harden RN. CRPS: Current Diagnosis and Therapy. Seattle, Wash: International Association for the Study of Pain; 2005.
-
8.
Wilson PR, Stanton-Hicks M, Harden RN. Preface. In: Wilson PR, Stanton-Hicks M, Harden RN. CRPS: Current Diagnosis and Therapy. Seattle, Wash: International Association for the Study of Pain Press; 2005.
-
9.
Loeser JD. Introduction. In: Wilson PR, Stanton-Hicks M, Harden RN. CRPS: Current Diagnosis and Therapy. Seattle, Wash: International Association for the Study of Pain Press; 2005.
-
10.
Wilson PR, Bogduk N. Retrospection, Science and Epidemiology. In: Wilson PR, Stanton-Hicks M, Harden RN. CRPS: Current Diagnosis and Therapy. Seattle, Wash: International Association for the Study of Pain Press; 2005.
-
11.
PDR Medical Dictionary, First Edition. Montvale, NJ: Medical Economics; 1995.
-
12.
Stedman's Online Medical Dictionary. Available at: www.stedmans.com/section.cfm/45. Accessed June 29, 2006.
-
13.
Dorland's Illustrated Medical Dictionary, 29th Edition. Philadelphia, Pa: Saunders Company; 2000.
-
14.
Harden RN, Bruehl SP. Diagnostic Criteria: The Statistical Derivation of the Four Criterion Factors. In: Wilson PR, Stanton-Hicks M, and Harden RN. CRPS: Current Diagnosis and Therapy. Seattle, Wash: International Association for the Study of Pain Press; 2005.
-
15.
Harden RN, Baron R, Janig W, (eds). Complex Regional Pain Syndrome. Seattle, Wash: International Association for the Study of Pain Press; 2001.
-
16.
Veldman P. Clinical Aspects of Reflex Sympathetic Dystrophy. Dissertation: Catholic University of Nijmegen; 1995.
-
17.
van de Beek WJ, Schwartzman RJ, van Nes SI. Diagnostic criteria used in studies of reflex sympathetic dystrophy. Neurology. 2002,58(4):522–526.
-
18.
Reinders MF, Geertzen JH, Dijkstra PU. Complex regional pain syndrome type I: use of the International Association for the Study of Pain diagnostic criteria defined in 1994. Clin J Pain. 2002;18:207–215.
-
19.
Landau WM. Reflex sympathetic dystrophy. Mayo Clinic Proceedings. 1996; 71:524–525.
-
20.
Stanton-Hicks M. Reflex sympathetic dystrophy: changing concepts and taxonomy. Pain. 1995;63:127–133.
-
21.
Breuhl S, Harden RN, Galer BS, et al. Complex regional pain syndrome: are there distinct subtypes and sequential stages of the syndrome? Pain. 2002;95:119–124.
-
22.
Barth RJ: Complex regional pain syndrome type 1 (reflex sympathetic dystrophy) - obstacles to acceptance as an occupational medicine entity. The Occup and Environ Med Rep. 2003:17;69–76.
-
23.
Barth RJ, Bohr TW: Challenges in the IASP's diagnostic conceptualization for CRPS I (formerly conceptualized as RSD), part 1. The Guides Newsletter. January-February 2006:4–12.
-
24.
Barth RJ, Bohr TW: Challenges in the IASP's diagnostic conceptualization for CRPS I (formerly conceptualized as RSD), part 2. The Guides Newsletter. March-April 2006:1–11.
-
25.
Stanton-Hicks M. Complex regional pain syndrome (type I, RSD; type II, causalgia): controversies. Clin J Pain. 2000:16(2 Suppl);S33–40.
-
26.
Pawl RP. Controversies surrounding reflex sympathetic dystrophy: a review article. Curr Rev Pain. 2000:4(4); 259–267.
-
27.
Fournier RS, Holder LE. Reflex sympathetic dystrophy: diagnostic controversies. Semin Nucl Med. 1998:28(1); 116–123.
-
28.
Ochoa JL. Truths, errors, and lies around “reflex sympathetic dystrophy” and “complex regional pain syndrome”. J Neurol. 1999:246;875–879.
-
29.
Grabow TS, Christo PJ, Raja SN. Complex regional pain syndrome: diagnostic controversies, psychological dysfunction, and emerging concepts. Adv Psychosom Med. 2004:25;89–101.
-
30.
Nath RK, Mackinnon SE, Stelnicki E. Reflex sympathetic dystrophy. The controversy continues. Clin Plast Surg. 1996:23;435–446.
-
31.
Kasdan ML, Johnson AL. Reflex sympathetic dystrophy. Occup Med. 1998:13;521–531.
-
32.
Manchikanti L. The role of radiofrequency in the management of complex regional pain syndrome. Curr Rev Pain. 2000:4;437–44.
-
33.
van de Vusse AC, et al. Discrepancy between complaints and objective signs in chronic regional pain syndrome: a multi-observer study. The Pain Clin. 2002:13;245–249.
-
34.
Sandromi P, et al. Complex regional pain syndrome type I: incidence and prevalence in Olmsted county, a population-based study. Pain. 2003:103; 199–207.
-
35.
Marchettini P, Lacerenza M, Formaglio F. Sympathetically maintained pain. Curr Rev Pain. 2000:4;99–104.
-
36.
Barth RJ. Chapter 14 or 18 for pain complaints? Part 4: summation, case example, and broader implications. The Guides Newsletter. July-August 2005: 4–7.
-
37.
Barth RJ. Chapter 14 or 18 for pain complaints? Part 3: guidance from chapter 18 and other pain resources. The Guides Newsletter. May-June 2005:1-3, 10–12.
-
38.
Barth RJ. Chapter 14 or 18 for pain complaints? Guidance from Chapter 14 and other mental health resources. The Guides Newsletter. March-April 2005: 4-5, 8–9.
-
39.
Barth RJ, Brigham CR. Chapter 14 or 18 for pain complaints? Avoiding the common but mistaken dichotomy of psychological vs organic. The Guides Newsletter. January-February 2005:1-3, 10–11.
-
40.
Zachariae L. Instance and course of posttraumatic dystrophy following operation for Dupuytren's contracture. Acta Chirurgica Scandinavica. 1964: 15;SUPPL 336;1–51.
-
41.
Harden RN, Bruehl S, et al. Prospective examination of pain-related and psychological predictors of CRPS-like phenomena following total knee arthroplasty: a preliminary study. Pain. 2003:106;393–400.
-
42.
Monti DA, Herring CL, Schwartzman RJ, Marchese M. Personality assessment of patients with complex regional pain syndrome type I. Clin J Pain. 1998;14:295–302.
-
43.
Bruehl S. Do Psychological Factors Play a Role in the Onset and Maintenance of CRPS I? In: Harden RN, Baron R, Janig W. Complex Regional Pain Syndrome. Seattle, Wash: International Association for the Study of Pain Press; 2001.
-
44.
Brigham CR, Ensalada LH, Talmage JB. The Guides Casebook, Second Edition. Chicago, Ill: American Medical Association; 2002.
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