text: We are contacted occasionally by people who, following an accident, have developed a condition known as Erythromelalgia. For the reasons explained below, bringing a compensation claim for this condition is far from straightforward.
  What is Erythromelalgia?
  Erythromelalgia, which was once more commonly referred to as Mitchell’s disease, is a rare condition affecting the extremities, although it is far more often found in the feet than the hands. The condition, which is considered a type of neuropathic pain, is characterised by intense burning pain, increased skin temperature and severe redness.
  For anybody familiar with the symptoms of Complex Regional Pain Syndrome (CRPS) there are a number of similarities between the two conditions and distinguishing them, particularly in the early stages, can prove difficult. Both conditions can result in hot, swollen and painful limbs.
  However, there are a number of differences between Erythromelalgia and CRPS. These include:
  - In most cases, Erythromelalgia is bilateral (ie it affects both limbs) whereas CRPS is more usually unilateral.
  - The allodynia of CRPS means that sufferers avoid exposure to the cold. Indeed, exposure to extreme cold (for example, applying ice to an affected limb) can have very severe repercussions for them. On the contrary, the symptoms of Erythromelalgia are actually relieved by exposure to cold.
  - The trigger for the onset of CRPS is usually some form of injury or trauma whereas people who develop Erythromelalgia commonly report no corresponding injury.
  What causes Erythromelalgia?
  Although in a small number of cases (up to 15%) there is thought to be a genetic predisposition to the condition, in most cases the cause of Erythromelalgia is not exactly clear. There is thought to be a connection to a dysfunction in the normal narrowing and widening of certain blood vessels, leading to abnormalities of blood flow to the extremities, but there is no settled opinion on what might trigger this.
  Erythromelalgia Compensation Claims
  It is this uncertainty over the cause of the condition and the fact that it can occur spontaneously that makes pursuing a claim for Erythromelalgia so fraught with difficulty.
  To succeed in any claim for personal injury, the claimant must be able to prove on the ‘balance of probabilities’ (ie that it is more likely than not) that their injury or medical condition was caused by the accident. The more likely that the claimant would have developed the condition in any event, the less likely the claim is to succeed.
  The ‘proof’ required comes from the evidence of medical experts. If a claim for Erythromelalgia is pursued, it is one of the best examples of a situation where the solicitor’s selection of medical experts is absolutely crucial to success.