Malibu, Summer 1997

The 2-day workshop of 29 faculty was held at a small facility, the Malibu Bay Inn in conjunction with the American Pain Society’s (APS) Annual Conference in Los Angeles under the auspices of the SIG, Pain and the Sympathetic Nervous System, IASP during the summer of 1997 to continue the work already begun in Orlando.Apart from the two basic scientists and a neurophysiologist, all of the group are clinicians representing medical disciplines that are associated in some way with the management of patients suffering from CRPS. The aim of this workshop is a continuum of the two earlier workshops in addition to moving the frontiers of diagnostic criteria, taxonomy and their place in medical practice and any clinical questions concerning the development of a simple algorithmic tool that could be used by a wide spectrum of medical practitioners. Such an algorithm would assist in an orderly approach to the management of RSD patients and one that is based on our current understanding of its pathophysiology and what clinical approaches have proved to be the most helpful in the absence of any mechanistic-based treatment. The Workshop was also designed to address those animal model behaviors that can translate to the signs and symptoms that are seen in clinical practice already described earlier in this account. The Proceedings of this workshop will determine the factors that will be used to validate standardized diagnostic criteria and a pathophysiology that will determine ultimately form the basis for CRPS treatment. The new complex regional pain syndrome, IASP/CRPS criteria developed during the Orlando conference (Stanton-Hicks et al. 1995) will encompass all those pain conditions that are associated with vasomotor and sudomotor disturbances and will replace all of the previous variety of diagnostic schemes (Blumberg 1991; Gibbons and Wilson 1992; Wilson et al. 1996). The lack of empirical validation of the IASP/CRPS criteria has already been questioned by Norman Hardin above—edema, sudomotor signs and symptoms, vasomotor aspects and motor/trophic signs are already included within criterion three of the proposed changes to the IASP/CRPS criteria.