Complex Regional Pain Syndrome

Bryan S. Williams, MD, MPH
Assistant Professor of Anesthesiology

Timothy Lubenow, MD
Professor of Anesthesiology

Division of Pain Medicine
Rush Medical College
Rush University Medical Center
Chicago, IL

Introduction - TOP

During the American Civil War Dr. Silas Weir Mitchell first described a condition in soldiers following gunshot injuries occurring near major nerves. This description included “intense burning sensation, but becomes exquisitely hyperanesthetic, so that a touch or tap of the finger increases the pain.”1 In 1864 Dr. Mitchell coined the term causalgia to describe the condition in which, “long after the trace of the effects of a wound has gone, neuralgic symptoms are apt to linger, and too many carry with them throughout long years this final reminder of the battle-field.”2 At the turn of the century Dr. Paul Hermann Sudeck described the condition in which relatively trivial injuries result in osteoporotic changes near the site of injury (Sudeck’s atrophy).3-5 Rene Leriche was the one of the first to implicate the sympathetic nervous system as a mediating factor in the condition.6 The term “reflex sympathetic dystrophy” (RSD) was introduced to reflect the proposed disruption in the sympathetic nervous system to the affected area.7 Since the early descriptions of this painful condition many names have been applied to the features that culminate in the syndrome (Table 1). 

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