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Objectives: This study aimed to identify relationships between sensory function and pain in 3 common pain conditions (arthritis, Complex Regional Pain Syndrome [CRPS] and fibromyalgia syndrome [FMS]) and pain-free participants. Sensory abnormalities are known to be concomitant with some types of chronic pain but comparison across pain conditions using existing research is difficult due to methodological differences. Pragmatic Quantitative Sensory Testing (QST) methods were used., Materials and Methods: Hot and cold sensitivity, light touch threshold (LTT), two-point discrimination and pain threshold were assessed in 143 participants (n=37 pain-free, n=34 arthritis, n=36 CRPS, n=36 FMS). Outcomes were assessed in the index ("affected" or right) and contralateral arm. Participants also completed the Brief Pain Inventory and the McGill Pain Questionnaire., Results: There were statistically significant differences between groups for all QST outcomes except two-point discrimination. Relative to pain-free participants, FMS displayed heat hyperesthesia in both arms and cold hyperesthesia in the contralateral arm. CRPS demonstrated no changes in thermal sensitivity. Both CRPS and FMS exhibited bilateral pressure hyperalgesia. LTT hypoesthesia was observed bilaterally for CRPS but only in the contralateral arm for FMS. CRPS and FMS had pressure hyperalgesia in the index arm relative to arthritis patients. There were no differences between arthritis and pain-free participants for any QST outcome. In CRPS, there were significant correlations between LTT and pain outcomes bilaterally., Discussion: People with FMS and CRPS demonstrate extensive sensory dysfunction. Arthritis patients had sensory profiles closer to pain-free participants. LTT may provide a clinically relevant and accessible assessment for CRPS.

Background: Complex regional pain syndrome is a painful and disabling post-traumatic primary pain disorder. Acute and chronic complex regional pain syndrome (CRPS) are major clinical challenges. In Europe, progress is hampered by significant heterogeneity in clinical practice. We sought to establish standards for the diagnosis and management of CRPS., Methods: The European Pain Federation established a pan-European task force of experts in CRPS who followed a four-stage consensus challenge process to produce mandatory quality standards worded as grammatically imperative (must-do) statements., Results: We developed 17 standards in 8 areas of care. There are 2 standards in diagnosis, 1 in multidisciplinary care, 1 in assessment, 3 for care pathways, 1 in information and education, 4 in pain management, 3 in physical rehabilitation and 2 on distress management. The standards are presented and summarized, and their generation and consequences were discussed. Also presented are domains of practice for which no agreement on a standard could be reached. Areas of research needed to improve the validity and uptake of these standards are discussed., Conclusion: The European Pain Federation task force present 17 standards of the diagnosis and management of CRPS for use in Europe. These are considered achievable for most countries and aspirational for a minority of countries depending on their healthcare resource and structures., Significance: This position statement summarizes expert opinion on acceptable standards for CRPS care in Europe., (© 2019 European Pain Federation - EFIC®.)