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The History and Names of Complex Regional Pain Syndrome (CRPS) | CRPS Awareness
The History and Names of Complex Regional Pain Syndrome
Complex Regional Pain Syndrome (CRPS) has a rich history with multiple names that have evolved over the centuries. Understanding this history is crucial as we strive to find a cure and raise awareness for CRPS. Join us in exploring the fascinating names and history of this complex disease that continues to perplex us.
WARRIORS of CRPS makes every effort to provide abundant and accurate information all on one website. Our hope is to help everyone with CRPS and lead the next generation of pharmaceuticals down a path of non-narcotics, creating a three-phase study on an Rx that we know can work miracles for patients. We also hope to create new legislation for CRPS sufferers. Please join us in keeping CRPS, synonymous with Complex Regional Pain Syndrome, as defined by IASP. If everyone uses CRPS consistently, we may all build more awareness. Use #CRPS and #WARRORIRSofCRPS when online on all social media! This disease will grow exponentially over the next handful of years; therefore, we need to stick to this one name if we expect to spread awareness.
The Father of American Neurology
The earliest known documented case of CRPS dates back to the 16th century when King Charles IX described symptoms of burning pain disproportionate to his injury during a bloodletting procedure.
However, it was Silas Weir Mitchell, known as “The Father of American Neurology,” who discovered CRPS during the American Civil War. In 1864, Mitchell, along with Morehouse and Keen, established CRPS as a medical condition, detailing its symptoms and recognizing the disproportionate pain experienced by patients.
What’s in a Name?
Over the years, CRPS has had more than 200 names, leading to confusion and limited awareness. Let’s trace the journey of names for this condition:
The original name given to the condition was Causalgia, combining the Greek words for “fire” and “pain.” This name held for about 80 years and is still evocative of the burning sensations associated with CRPS. In 1900, Peter Sudeck introduced the theory of “Sudeck’s Atrophy,” describing the cardinal signs of inflammation and making significant strides in understanding post-traumatic pain syndrome.
After World War II, James A. Evans renamed the condition Reflex Sympathetic Dystrophy (RSD) to emphasize the involvement of the sympathetic nervous system. This name gained popularity among physicians, but it faced criticism for its limitations in accurately characterizing the condition.
Following Peter Suddeck’s theory, sixteen years later, Rene Larchin, a French military surgeon, was finally able to take Silas Weir Mitchell, Peter Sudeck, and others’ discoveries and make the link to the sympathetic nervous system. Rene Larchin noted that the limbs of patients with causalgia showed features that were consistent with vascular insufficiency and proposed that the pain might be alleviated by sympathectomy. Leriche went on to confirm his hypothesis of relieving arm pain by stripping 12 cm of adventitia from the brachial artery of a patient with causalgia. Based on this experience, Leriche went on to promote resection of the inferior cervical ganglia for the treatment of cardiac angina. Although Leriche later retracted his hypothesis, the sympathetic component became ingrained in the concepts of RSD and causalgia for nearly 100 years.
The International Association for the Study of Pain (IASP)
The establishment of the International Association for the Study of Pain (IASP) in 1973 by John J. Bonica marked a turning point in pain research and management. In 1994, the IASP updated the name to Complex Regional Pain Syndrome (CRPS) and reintroduced the term causalgia as a subtype. CRPS Type I was associated with an initiating event and evidence of specific symptoms, while CRPS Type II indicated direct nerve injury. A third type, CRPS Type NOS, was added for those with unexplained symptoms.
Spread Awareness, Stick to One Name.
Although CRPS is not widely known outside of specialized circles, spreading awareness is crucial. By using the consistent term CRPS and incorporating hashtags like #CRPS and #WARRIORSofCRPS on social media, we can build greater awareness of this disease and support ongoing research.
Join us in unraveling the history of CRPS, fostering understanding, and striving for a future without the burden of this enigmatic condition.
Complex Regional Pain Syndrome (CRPS)
Fast forward eight years, and finally, the foot-stomping, fist-shaking, and demands of the medical professionals that study this condition day in and day out finally caught the ears of the now-established IASP, and in 1994, the name was finally updated to Complex Regional Pain Syndrome, CRPS. The IASP even went back to the roots and agreed that the term causalgia had some meaning and determined that the name had reasoning and reasoned that there should be types.
- RSD was renamed CRPS Type I – defined as a “syndrome” that usually develops after an initiating noxious event, is not limited to the distribution of a single peripheral nerve, and is apparently disproportionate to the inciting event. It is associated at some point with evidence of edema, changes in skin blood flow, abnormal sudomotor activity in the region of the pain, or allodynia or hyperalgesia.”
- Causalgia was renamed CRPS Type II – wherein there is direct injury or damage to a nerve, such as during surgery, amputation, or due to an incision, and is used for the painful condition associated with a peripheral nerve injury.
- CRPS Type NOS – On February 1, 2018, the IASP met and updated these types again, and they added a third type to include those who did not accurately fit into either area but nonetheless had symptoms that could not be explained by any other disease.
To this day, the term CRPS is not widely known outside subspecialty circles, and many physicians continue to use the terms RSD and Causalgia.
