Complex regional pain syndrome: my minimum evidence standard
The NDIS looks for the same chain of evidence whether it's deciding on access or on a support. This page sets out the minimum I'd expect that evidence to contain for complex regional pain syndrome (CRPS): how the condition and its pain are classified, what the diagnosis is checked against, what treatment has been tried, and how day-to-day function is recorded over time. It's the same method I use on every file.
It's about the file, not your treatment. Questions about your own care belong with your GP or treating specialist.
What the condition isSteps 1–3
Step 01
CRPS is classified in ICD-11 as chronic primary pain, which makes the pain the condition
ICD-11 classification
In ICD-11, complex regional pain syndrome sits within chronic primary pain, alongside fibromyalgia. This matters for your file: it means the pain is a diagnosis in its own right, even where it began with an injury that has since healed.
A strong file names the classification, the type, and the extra details ICD-11 asks for (its specifiers).
| Code | Level | Term |
|---|---|---|
| MG30 | Parent | Chronic pain |
| MG30.0 | Subclass | Chronic primary pain |
| MG30.04 | Category | Complex regional pain syndrome · type I (no confirmed nerve lesion) or type II (with one) |
| Specifiers | Side (left, right, bilateral) · body region · severity, distress and interference (mild, moderate, severe) · psychosocial factors (present, not present) |
The next step is what's driving the pain.
Step 02
CRPS pain has more than one mechanism, and that shapes which treatment evidence attaches to it
Pain mechanism
Pain is classified by mechanism: nociceptive (from tissue), neuropathic (from nerve injury or disease), or nociplastic (from altered pain processing in the nervous system). CRPS is usually described as mixed: neuropathic and nociplastic features together, with changes in the nerves that control blood flow and sweating, and inflammation in the affected limb.
When your file names the mechanisms, each treatment can be matched to what it was aimed at. With a mixed condition like CRPS that's especially important: a treatment aimed at one mechanism can leave another untouched. If the file says which was which, the NDIS doesn't have to guess.
The next step is the criteria the diagnosis is checked against.
Refused access or a support for CRPS?
Bring your decision letter to a free 15-minute call, and we'll work out which requirement your file has to answer.
Step 03
CRPS is diagnosed against the Budapest criteria
Diagnostic criteria
AAPT has not published criteria for CRPS. The recognised standard is the Budapest criteria, adopted by the International Association for the Study of Pain and validated in 2010. They separate what a person reports (symptoms) from what a clinician observes (signs), across four categories.
| Criterion | What a strong file records | |
|---|---|---|
| 1 | Sensory | Reported: heightened pain sensitivity, or pain from light touch. Observed: pain to pinprick, or to light touch, pressure or joint movement. |
| 2 | Vasomotor | Reported: temperature or skin colour differences between limbs. Observed: measured temperature difference, or visible colour change. |
| 3 | Sudomotor and swelling | Reported: swelling, or sweating changes. Observed: swelling or sweating differences. |
| 4 | Motor and trophic | Reported: reduced movement, weakness, tremor or dystonia; hair, nail or skin changes. Observed: loss of movement, weakness, tremor or trophic change. |
Because signs vary over time, a strong file records which categories were met, on which date, and by whom. It also records how other explanations were considered. The differential depends on the region, and commonly includes vascular causes (such as clots or poor circulation), musculoskeletal causes (such as tendon inflammation or a fracture that has not healed), nerve conditions, inflammatory arthritis and infection.
Once the diagnosis is settled, the question most pain refusals come down to is what has been tried.
What has been done about itStep 4
Step 04
A CRPS treatment history is easiest to read when it covers the nine elements of pain management
Treatment history · s 24(1)(b)
Whether the NDIS accepts an impairment as permanent usually comes down to the treatment record. I check it against the nine elements of pain management (HEAPPPPSS). For each one, the table names a published review or guideline that covers it for CRPS or chronic pain. For a support request, the same record shows where treatment ends and disability support begins, which is how the NDIS decides whether the health system should fund it instead.
This table isn't a list of treatments you should have had. It shows what the published research covers. It isn't a recommendation for anyone's care, and it says nothing about what would suit you. Questions about your own treatment belong with your GP or treating specialist.
For each element in your file, the NDIS looks for what was done and what happened. If an element never appears, the file says nothing about it, and the NDIS decides what that silence means.
Permanence is one requirement. Function is the other one a CRPS file most often has to show.
What it costs to live withSteps 7 and 9
CRPS function is shown best across a whole day and the week that follows, not in one appointment
Function over time · s 24(1)(c)
CRPS often limits the most ordinary tasks: bathing, dressing or grooming the affected limb when water or fabric is intolerable, bearing weight, carrying, or fine hand use. Its cost also changes over the days after activity. A single appointment sees one task on one day, so it tends to make you look more capable than you are.
A strong file follows what happens after a run of ordinary activities. I follow up at 24 hours, 72 hours and 7 days.
| Contact | What your record usually shows |
|---|---|
| 24 h | Pain and sensitivity spikes, swelling, temperature or colour change in the limb, spread of burning pain |
| 72 h | Reduced movement in the affected joints, sweating or circulation changes, deep aching |
| 7 days | Whether the limb has returned to its usual state; guarding, fatigue, sleep disruption, and daily tasks not yet back to baseline |
For an access request, I then match what your file shows to the six activity domains in s 24(1)(c), the areas of daily life the NDIS assesses. For a support request, the same record shows what the support keeps you doing and what slips without it. Either way, that's done for each person, not for each condition.
Download the Pain, Sleep and Fatigue DiaryThree published CRPS decisions show how files like this have fared at the Tribunal.
What the decisions showFrom the index
In three published CRPS decisions, the diagnosis, the treatment record and function each decided the outcome
Complex regional pain syndrome is named in three of the 124 decisions in my index, as at 2 October 2026. Each one stopped at a different requirement.
Treatment record · not permanent
A recommended multidisciplinary pain service hadn't been tried, and it had a good prospect of substantially relieving the impairment.
Function · not substantially reduced
No further treatment would remedy the impairment, but function assessed against that impairment alone wasn't substantially reduced.
Diagnosis · CRPS not accepted
A supports review. The specialist found her features no longer met the CRPS criteria when he examined her.
These are published Tribunal decisions, not my clients. They show what three records did and didn't establish. Nothing here predicts any other matter.
There are two ways to start now.
Two ways to start on a CRPS file: the diary, or a free 15-minute call
If the NDIS refused access or a support for CRPS:
Start the Pain, Sleep and Fatigue Diary. One line a day, for four weeks. It records how each day went and the cost that arrives later, and the last page adds it up. It is free, whether or not you ever contact me.
Book a free 15-minute call. Bring your decision letter and we'll work out which requirement your file has to answer, and whether an Evidence Audit would help.
This page sets out my minimum standard for evidence. It is general information, not advice about anyone's treatment and not legal advice. Questions about your own care belong with your GP or treating specialist.