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Beyond the Surface: The True Name of CRPS

Exploring the History of CRPS 

Complex Regional Pain Syndrome (CRPS) has a traumatic history with its changed terminology that kept evolving with the developments in medicine. The first name was Reflex Sympathetic Dystrophy (RSD), alternatively called Causalgia and Algo dystrophy, reflecting several names to its name and the complexity of medical growth understanding. The term “Reflex Sympathetic Dystrophy” (RSD) was coined in the late 19th century by one of America’s more famous doctors, Silas Weir Mitchell. Mitchell was seeing patients who had chronic pain, often in the extremities and sometimes with changes in skin color, temperature, and swelling. The leading conviction then was that the sympathetic nervous system had a vital role in the pathogenesis of the symptoms. In his RSD hypothesis, Mitchell focused his attention on dysregulated sympathetic function and viewed faulty sympathetic activity as one of the main initiators of the syndrome.  

Medical advances have further transformed knowledge of the condition. CRPS was first described in 1993 by the International Association for the Study of Pain (IASP) to replace the stigmatized term RSD. The terminology shift indicated a more accommodative view of the perspective, primarily on the complexity of this disorder. The new name attempted to encompass an array of signs with their complex relations rather than merely sympathetic dysfunction as formerly done. The two varieties are CRPS type I, which previously used to be called RSD, and CRPS type II, one-time causalgia, depending on whether there is nerve injury. CRPS type I occurs without a demonstrated nerve lesion, while CRPS type II has identifiable distinct nerve lesions. Such stratification will guide physicians toward judiciously applying their approaches to therapeutics based on underlying mechanisms.  

The transitioning of medical terminology 

Change in terminology to CRPS from RSD represented transition and deeper understanding of the illness process beyond sympathetic dysfunction, emphasizing its complex neurological system, immune system, and other relationships. Other terminologies have been given upon disorders like CRPS after the evolution from RSD to CRPS. Algolagnia was first termed algolagnia as an attempt to equate it with the other conditions such as RSD and other highly painful conditions which caused sensitivity. Algolagnia became an invaluable term as it was neither specific nor precise due to the medical knowledge of the field. In its presentation in some different clinical conditions, CRPS made health difficult to understand and making it difficult to name. The complications between the contrasting symptoms that entail sharp pain, skin temperature and skin color changes, and swelling are hard to diagnose. Lack of reliable diagnostic test for CRPS hinders diagnosis, leading to nomenclature changes. 

The Significance of Research!  

Neurological and immunological bases are now attributed to CRPS. The cause of CRPS indirectly relates to immune dysregulation through research. Immune cells and other inflammatory mediators continue through the pain and other symptoms, highlighting the multifaceted requirement for diagnosis and therapy. Classical studies fashioned inclusive diagnostic criteria for CRPS to enhance accuracy and consistency. In 2003 criteria from Budapest were detailed, used for diagnosis and then revised in 2010. Clinical symptoms ascertained included sensory and motor complaints, skin color and temperature, edema, and physical examination.  

P2P is Here to Help 

At P2P, we stand with those affected by CRPS, which is why we are both sponsoring and donating to the CRPS Warriors Foundation. You can help too! For more information on Complex Regional Pain Syndrome and to donate to the foundation, visit our CRPS Warriors Page.  

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