How do I diagnose and manage Chronic Regional Pain Syndrome (CRPS)?

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Last updated: April 4, 2025 • View editorial policy

Differential Diagnosis for Chronic Regional Pain Syndrome

  • Single most likely diagnosis:

    • Complex Regional Pain Syndrome (CRPS): This is the most likely diagnosis given the description of chronic regional pain syndrome. CRPS is a chronic pain condition characterized by severe, burning pain at the site of an injury, usually an arm or leg. The pain is out of proportion to the severity of the initial injury and is often accompanied by swelling, changes in skin temperature and color, and sensitivity to touch.
  • Other Likely diagnoses:

    • Neuropathic pain: This could be a consideration if the pain is primarily due to nerve damage. Neuropathic pain can manifest as burning, shooting, or stabbing pain and can be chronic in nature.
    • Fibromyalgia: Although fibromyalgia is characterized by widespread pain, some patients may experience more localized pain that could be confused with chronic regional pain syndrome.
    • Chronic pain syndrome: This is a broader category that could encompass CRPS but also includes other chronic pain conditions not necessarily tied to a specific region or injury.
  • Do Not Miss diagnoses:

    • Osteomyelitis or bone infection: Chronic pain in a limb could be a sign of a deep-seated infection like osteomyelitis, which requires prompt antibiotic treatment and possibly surgery.
    • Deep vein thrombosis (DVT): DVT can cause chronic pain and swelling in a limb and is a medical emergency due to the risk of pulmonary embolism.
    • Peripheral artery disease: This condition can cause chronic pain in the legs, especially during exercise, due to reduced blood flow.
  • Rare diagnoses:

    • Erythromelalgia: A rare disorder characterized by burning pain, heat, and redness in the hands and feet, which could be mistaken for CRPS.
    • Reflex sympathetic dystrophy (a variant of CRPS): Although not entirely distinct from CRPS, some sources still refer to it separately, emphasizing the role of the sympathetic nervous system in the pain.
    • Sickle cell disease or other hemoglobinopathies: These conditions can cause episodes of severe pain due to vaso-occlusive crises, which might be localized to a region and could be confused with CRPS in some cases.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.