Chronic pain and complex regional pain syndrome
Most injuries hurt and then stop hurting. In a minority of people the pain persists long after the tissue has healed, and occasionally it escalates into something far worse. These are the hardest claims in injury law and among the most genuine.
Complex regional pain syndrome
CRPS is a condition in which pain following an injury — often a relatively minor one, classically a wrist fracture or a crush injury to a hand or foot — becomes disproportionate, persistent, and accompanied by physical changes in the limb.
- Allodynia — pain from things that should not hurt, such as a bedsheet or a light breeze
- Hyperalgesia — disproportionate pain from mildly painful stimuli
- Temperature and color change in the affected limb, often asymmetric
- Swelling, sweating changes, altered hair and nail growth
- Reduced range of motion, weakness, tremor, and eventually disuse changes
Diagnosis is clinical, usually against the Budapest criteria, which require symptoms across defined categories plus objective signs observed on examination. There is no single confirmatory test, which is exactly what makes these claims contested.
Those objective signs are the evidentiary key. Documented temperature asymmetry, measured swelling, photographed color change and recorded trophic changes are what turn a disputed pain complaint into a documented condition.
Why insurers fight these claims so hard
Because the pain is disproportionate to the original injury, because there is no scan that shows it, because the diagnosis is clinical, and because the damages are large — CRPS is frequently disabling and frequently permanent.
Expect surveillance. Expect social media to be examined. Expect a defense medical examination with a specialist who takes a skeptical view of the diagnosis. None of that is a reason not to bring the claim; it is a reason to document it meticulously and to be consistent, because inconsistency is what these defenses feed on.
Treatment, and the record it creates
Early mobilisation and physiotherapy are central; immobilising a painful limb makes CRPS worse. Beyond that, sympathetic nerve blocks, graded motor imagery and mirror therapy, medication aimed at neuropathic pain, and in refractory cases spinal cord stimulation.
A documented response — or failure to respond — to a targeted intervention such as a sympathetic block is objective evidence of a kind these claims badly need, which is one more reason to pursue proper specialist care rather than endure it.
Questions people ask
What is CRPS?
Complex regional pain syndrome: persistent pain after an injury that is disproportionate to the original trauma, accompanied by physical changes in the limb such as temperature and color change, swelling, and altered hair or nail growth. It is diagnosed clinically, commonly against the Budapest criteria, because there is no single confirmatory test.
Why does the insurer say I am exaggerating?
Because the pain is out of proportion to the original injury and no scan shows it, which is a feature of the condition rather than evidence against it. The answer is meticulous documentation of the objective signs — measured temperature asymmetry, photographed color change, recorded swelling and range of motion — by treating specialists.
Am I likely to be followed or filmed?
In a large chronic pain claim, surveillance is common and lawful in public places. Pain fluctuates, so a good day on film gets used against a bad day in testimony. Being accurate and consistent, including about your better days, is the best protection there is.
Related
Reviewed October 2026 by Simon Aziz Budhwani, Esq., the attorney responsible for this site. Legal statements here name the California code section they rely on, so you can check them rather than trust them. This is information about the law in general, not advice about your situation.
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