Objective assessment of clinical features and level of impairment in patients suffering from Complex Regional Syndrome: a review

Andrzej Żyluk, Nadine Hollevoet


The diagnosis of complex regional pain syndrome (CRPS) is made on clinical grounds, based on the presence of several symptoms and signs that are relatively easy to find when recording the patient’s history and in the clinical examination. It is not as easy, however, to quantify these features. Maintaining objectivity is desired in clinical practice, and is particularly important in research studies. Complex regional pain syndrome causes a functional impairment of the affected extremities and limits daily living activity in the patients. An objective measurement of these limitations is also desired. In this paper we present methods used in contemporary research on CRPS, attempting to objectivize features that are primarily subjective, such as pain and level of impairment. The methods of assessment of these variables are useful in studies on the impact of the disease on patient functioning in daily living. They are also important in a complex assessment of the results of treatment of the condition.


CRPS – diagnosis; disability; outcome measurement; questionnaire

Full Text:



Żyluk A. Zespół Sudecka, algodystrofia, CRPS. Warszawa: PZWL; 2015.

Żyluk A, Puchalski P. Complex regional pain syndrome of the upper limb: a review. Neurol Neurochir Pol 2014;48(3):200-5.

Żyluk A, Puchalski P. Complex regional pain syndrome: observations on diagnosis, treatment and definition of a new subgroup. J Hand Surg 2013;38(6):599-606.

Żyluk A. Complex regional pain syndrome type I. Risk factors, prevention and risk of recurrence. J Hand Surg Br 2004;29(4):334-7.

Żyluk A, Puchalski P. Treatment of early complex regional pain syndrome type 1 by a combination of mannitol and dexamethasone. J Hand Surg Eur Vol 2008;33(2):130-6.

Żyluk A, Mosiejczuk H. A comparison of the accuracy of two sets of diagnostic criteria in the early detection of complex regional pain syndrome following surgical treatment of distal radial fractures. J Hand Surg Eur Vol 2013;38(6):609-15.

Oerlemans MH. Reflex sympathetic dystrophy: development of measurement instruments and outcome of a randomized controlled clinical study on physiotherapy and occupational therapy. MD thesis 1999. Amsterdam: University of Nijmegen and University of Amsterdam; 1999. p. 51-156.

Melzack R. The McGill Pain Questionnaire: major properties and scoring methods. Pain 1975;1(3):277-99.

Davidoff G, Morey K, Amann M, Stamps J. Pain measurement in reflex sympathetic dystrophy syndrome. Pain 1988;32(1):27-34.

Żyluk A. Pain mechanisms in complex regional syndrome type 1: a review. Chir Narzadow Ruchu Ortop Pol 2009;74(4):244-9.

Irwin MS, Gilbert SE, Terenghi G, Smith RW, Green CJ. Cold intolerance following peripheral nerve injury. Natural history and factors predicting severity of symptoms. J Hand Surg Br 1997;22(3):308-16.

Żyluk A. A new clinical severity scoring system for reflex sympathetic dystrophy of the upper limb. J Hand Surg Br 2003;28(3):238-41.

Żyluk A, Piotuch B. Use of questionnaires in the assesment of outcomes in hand surgery. Chir Narzadow Ruchu Ortop Pol 2009;74(4):193-201.

Żyluk A, Skała K, Szlosser Z. A comparison of outcomes of K-wire vs plate fixation for distal radial fractures with regard to patients’ quality of life. Acta Orthop Belg 2018;84(4):546-53.

Bond FW, Hayes SC, Baer RA, Carpenter KM, Guenole N, Orcutt HK, et al. Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: A revised measure of psychological inflexibility and experiential avoidance. Behav Ther 2011;42(4):676-88.

DOI: https://doi.org/10.21164/pomjlifesci.815

Copyright (c) 2022 Andrzej Żyluk, Nadine Hollevoet

License URL: https://creativecommons.org/licenses/by-nc-nd/3.0/pl/