Complex regional pain syndrome
Meaning of complex regional pain syndrome: For the purposes of this Statement of Principles, complex regional pain syndrome means a disorder of a body region or regions which meets the following criteria: (a) continuing pain, which is disproportionate to any inciting event; and (b) at least one symptom in two of the four following categories: (i) sensory: hyperalgesia or allodynia; (ii) vasomotor: temperature asymmetry or skin colour changes or skin colour asymmetry; (iii) sudomotor/oedema: oedema or sweating changes or sweating asymmetry; or (iv) motor/trophic: decreased range of motion or motor dysfunction (weakness, tremor, dystonia) or trophic changes (hair, nails, skin); and (c) at least one sign at the time of evaluation in two or more of the following categories: (i) sensory: evidence of hyperalgesia (to pinprick) or allodynia (to light touch and/or deep somatic pressure or joint movement); (ii) vasomotor: evidence of temperature asymmetry or skin colour changes or asymmetry; (iii) sudomotor/oedema: evidence of oedema or sweating changes or sweating asymmetry; or (iv) motor/trophic: evidence of decreased range of motion or motor dysfunction (weakness, tremor, dystonia) or trophic changes (hair, nails, skin).
Reasonable Hypothesis (RH) — Statement of Principles No. 97 of 2016
At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting complex regional pain syndrome or death from complex regional pain syndrome with the circumstances of a person's relevant service:
- (1)having an injury or a disease involving a major peripheral nerve in the six months before the clinical onset of complex regional pain syndrome, where the pain originates in the region of the affected peripheral nerve;
- (2)having an injury or a disease from the specified list of injuries or diseases in the six months before the clinical onset of complex regional pain syndrome, where the pain originates in the region of the body affected by the injury or disease;
Note: specified list of injuries or diseases is defined in the Schedule 1 - Dictionary.
- (3)having surgery in the six months before the clinical onset of complex regional pain syndrome, where the pain originates in the region of the surgical procedure;
- (4)being treated with phenobarbital at the time of the clinical onset of complex regional pain syndrome;
- (5)inability to obtain appropriate clinical management for complex regional pain syndrome;
Aggravation-only factors: the factors in subsection 8(5) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.
Balance of Probabilities (BoP) — Statement of Principles No. 98 of 2016
5 factors
At least one of the following factors must exist before it can be said that, on the balance of probabilities, complex regional pain syndrome or death from complex regional pain syndrome is connected with the circumstances of a person's relevant service:
- (1)having an injury or a disease involving a major peripheral nerve in the six months before the clinical onset of complex regional pain syndrome, where the pain originates in the region of the affected peripheral nerve;
- (2)having an injury or a disease from the specified list of injuries or diseases in the six months before the clinical onset of complex regional pain syndrome, where the pain originates in the region of the body affected by the injury or disease;
Note: specified list of injuries or diseases is defined in the Schedule 1 - Dictionary.
- (3)having surgery in the six months before the clinical onset of complex regional pain syndrome, where the pain originates in the region of the surgical procedure;
- (4)being treated with phenobarbital at the time of the clinical onset of complex regional pain syndrome;
- (5)inability to obtain appropriate clinical management for complex regional pain syndrome;
Aggravation-only factors: the factors in subsection 8(5) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.
