Dougie Natusch is a pain consultant in South Devon NHS. He explains the signs and symptoms associated with the Bruehl criteria used to diagnose the syndrome of Complex Regional Pain Syndrome (CRPS), the epidemiology, natural history, pathiophysiological theories of CRPS and a detailed examination of the evidence supporting the treatments and therapies applied to those theories. He concludes that there is no overwhelming evidence for any particular treatment and that the correct management should be patient centred rather than doctor or therapist centred. His own experience with treating CRPS is that early initiation of movement of the affected limb is probably the most important factor.

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