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What are the Budapest Criteria for Complex Regional Pain Syndrome (CRPS)?

Janice Rocker, OTD, OTR/L, CHT, CEAS

May 15, 2023

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Question

What are the Budapest Criteria for Complex Regional Pain Syndrome (CRPS)?

Answer

Budapest Criteria for CRPS

  • Pain and at least one symptom in 3 of these categories:
    • Sensory: hyperalgesia and/or allodynia
    • Vasomotor: temperature asymmetry and/or skin color changes and/or skin color asymmetry
    • Sudomotor/Edema: edema and/or sweating changes and/or sweating asymmetry
    • Motor/Trophic: decreased range of motion and/or motor dysfunction (weakness, tremor, dystonia) and/or trophic changes (hair, nail, skin)
  • Must display at least one sign at the time of evaluation in two or more of the following categories:
    • Sensory: hyperalgesia (to pinprick) and/or allodynia (to light touch and/or deep somatic pressure and/or joint movement)
    • Vasomotor: temperature asymmetry and/or skin color changes and/or asymmetry
    • Sudomotor/Edema: edema and/or sweating changes and/or sweating asymmetry
    • Motor/Trophic: decreased range of motion and/or motor dysfunction (weakness, tremor, dystonia) and/or trophic changes (hair, nail, skin)
  • There is no other diagnosis that better explains the signs and symptoms

https://www.blbchronicpain.co.uk/news/what-are-the-crps-budapest-criteria/

The Budapest criteria are the best way to classify someone as having CRPS and the gold standard. We can observe these changes in the clinic. There are also clinical tests that can be run.

If you are seeing symptoms and are unsure where to classify them, this is a nice reference to use.

Additional resource: 

AOTA (2021).  Position statement-role of OT in pain management. AJOT, 75(Suppl.3), 7513410020. doi.org/10.5014/ajot.2021.75S3001

 

This Ask the Expert is an edited excerpt from the course, Complex regional pain syndrome: Functional, biomechanical, and psychosocial interventions, Janice Rocker, OTD, OTR/L, CHT, CEAS.


janice rocker

Janice Rocker, OTD, OTR/L, CHT, CEAS

Janice Rocker received her clinical Doctor of Occupational Therapy degree from USC in 2014, and her master's degree in occupational therapy from Boston University in 1985. She passed the Hand Therapy Certification exam when it was first offered in 1991. In 2005, she became a Certified Structural Yoga Therapist to help her clients manage stress and pain due to injury or degenerative conditions. She is also a Certified AOTA Fieldwork Educator (2014), and a Certified Ergonomic Assessment Specialist (2019).

Dr. Rocker has lectured on wound healing, custom static and dynamic orthotic fabrication, ergonomics, physical agent modalities, joint protection, cumulative trauma, body mechanics, and hand/upper extremity rehabilitation. She has published articles in the American Journal of Occupational Therapy, OT Practice magazine and in the American Society of Hand Therapists quarterly newsletter.  She coordinated the outpatient hand and upper extremity rehabilitation program at the Keck Medical Center of USC, LA, California, from December 2007 through September 2022.

Recent presentations include September 2022, invited speaker at the USC monthly Hand Conference for MDs, fellows, and residents:  OT Hand Rehabilitation & MD Collaboration.  October 2021, selected to present at the American Society of Hand Therapists Annual Conference:  Beyond Xiaflex & McCash:  Needle Aponeurotomy, Radiotherapy & Rehabilitation for Recurrent Dupuytren’s Disease; also selected to present a research poster: American & International Student Perceptions on Educational & Mentoring Opportunities, Barriers, & Resources Needed for Global Hand Therapy.


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