The affected limb is often warm, red and oedematous in early CRPS within 6 months of injury.5 6 Blister fluid from the skin of the affected limb has high levels of the proinflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) when compared with the contralateral limb’s skin blister.7 Early anti-inflammatory treatment with glucocorticoid in patients with CRPS can be effective.8 It is difficult to explain the peripheral tissue changes in skin and bone in particular through a solely neurogenic mechanism. Here, TNF is linked to complex regional pain syndrome.