Chronic regional pain and chronic pain syndromes.

This paper seeks to consider the validity and utility of two related terms in spinal and other injuries: complex regional pain syndrome (CRPS) and chronic pain syndrome (CPS). It is argued that the words chronic regional pain syndrome convey neither understanding of the condition nor of its mechanism. They simply redefine the clinical problem, but fail to establish specific diagnostic features or consistent primary pathogenesis. CRPS is best construed as a reaction to injury, or to excessive, often iatrogenic, immobilization after injury; but it is not an independent disease. The diagnosis of CPS groups together ill-defined symptoms under a convenient, but medically untestable and therefore inept label. Patients, lawyers, and support groups commonly deny psychogenesis, with the sadly mistaken notion that this implies a bogus or spurious cause.