Nevner sammenhengen mellom nervebetennelser, stress, depresjon, m.m. i kroniske smerter. Bl.a. at «varm» vs «kald» tilstand i hånden viser til om det er i starten eller har pågått lenger enn 1 år. Den «kalde» tilstanden er mer smertefull.
«we developed a model based on interaction analysis suggesting a complex hierarchical interaction of peripheral (injury/sensory loss) and central factors (pain/disability/stress/depression) predicting motor dysfunction and hyperalgesia.»
«As the presence of an inducible autonomic nervous system autoantigen has been recently demonstrated in CRPS patients, one may speculate about possible interactions between autoimmune and inflammatory processes dominating the acute phase of CRPS, whereas in chronic CRPS the clinical signs of peripheral neurogenic inflammation and autonomic dysfunction may have mostly subsided due to post-inflammatory burn-out.»
«Furthermore, it has been demonstrated that patients initially classified as “cold” CRPS showed more pain when re-evaluated several years after the initial assessment . “Warm” CRPS seems to be predominant in the acute phase of CRPS, where signs of peripheral neurogenic inflammation dominate»