By Michael Serpell
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Additional info for Handbook of Pain Management
Cyanosis, pallor or asymmetry of limb temperature implies vascular or sympathetic involvement. Swelling and loss of hair growth or nail changes support the diagnosis of complex regional pain syndrome (CRPS). Posture gait and station should be examined. Range of motion of the spine does not correlate well with pathology. Testing knee and ankle reflexes in patients with radicular symptoms may determine the level of spinal cord compromise. Weakness with dorsiflexion of the great toe may indicate L5 dysfunction.
G. psychosocial features, may need to be considered. e. in conditions such as painful diabetic neuropathy or spinal cord injury). g. 5). It is less well localized and often described as burning or shooting. It can occur in areas that are numb and where there is no tissue damage. The Neuropathic Pain Scale (NPS)  was developed to quantify the components of neuropathic pain so that its progression or response to treatment could be followed over time. 6). Psychosocial features have been shown to be predictors of the incidence and duration of chronic pain.
Psychosocial features have been shown to be predictors of the incidence and duration of chronic pain. It is important to realize that this does not imply that the pain has a psychological basis, only that psychological and social factors may be important drivers in the severity and maintenance of pain, amount of functional impairment and degree of responsiveness to treatment. 5 Features of neuropathic pain t May be unaccompanied by ongoing tissue damage and also occur in an area of sensory loss t May be burning or lancinating in nature.