Sympathetic contribution to pain – need for clarification

Certain patients with a possible contribution of the sympathetic system to pain may not fit the definition of complex regional pain syndromes (CRPS), which raises the question of terminology for those patients. To further clarify the relationship between the sympathetic system and pain, apart from the need for placebo studies, there remains an urgent need for a satisfactory definition of the criteria for a complete sympathetic block. It also remains uncertain whether a change in the discharge pattern of sympathetic fibres underlies the changes in sympathetic organ function, often found in patients with CRPS.