Pain dysfunction syndrome is a descriptive term recommended by Amadio(
1) to describe patients whose pain is excessive, nonanatomic, and out
of proportion to their injury. This retrospective review reports the e
ffectiveness of a differential epidural block in the evaluation of the
se patients, Four patterns of response were identified with the block:
1) reflex sympathetic dystrophy (RSD) (14%), 2) somatic (9%), 3) mixe
d sympathetic and somatic (27%), and 4) central (50%). The inciting in
jury in 70% of the patients was a minor strain, sprain, or contusion,
Despite accurate diagnosis, the results in compensation cases with pai
n dysfunction syndrome are exceedingly poor.