CRPS Complex Regional Pain Syndrome

Complex regional pain syndrome (CRPS) is a chronic (lasting greater than six months) pain condition that most often affects one limb (arm, leg, hand, or foot) usually after an injury. CRPS is believed to be caused by damage to, or malfunction of, the peripheral and central nervous systems. The central nervous system is composed of the brain and spinal cord; the peripheral nervous system involves nerve signaling from the brain and spinal cord to the rest of the body. CRPS is characterized by prolonged or excessive pain and changes in skin color, temperature, and/or swelling in the affected area. CRPS is divided into two types: CRPS-I and CRPS-II. Individuals without a confirmed nerve injury are classified as having CRPS-I (previously known as reflex sympathetic dystrophy syndrome). CRPS-II (previously known as causalgia) is when there is an associated, confirmed nerve injury. As some research has identified evidence of nerve injury in CRPS-I, it is unclear if this disorders will always be divided into two types. Nonetheless, the treatment is similar. CRPS symptoms vary in severity and duration, although some cases are mild and eventually go away. In more severe cases, individuals may not recover and may have long-term disability.

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CRPS COMPLEX REGIONAL PAIN SYNDROME

Synonyms:
The key symptom is prolonged severe pain that may be constant. It has been described as “burning,” “pins and needles” sensation, or as if someone were squeezing the affected limb. The pain may spread to the entire arm or leg, even though the injury might have only involved a finger or toe. In rare cases, pain can sometimes even travel to the opposite extremity. There is often increased sensitivity in the affected area, known as allodynia, in which normal contact with the skin is experienced as very painful.

People with CRPS also experience changes in skin temperature, skin color, or swelling of the affected limb. This is due to abnormal microcirculation caused by damage to the nerves controlling blood flow and temperature. As a result, an affected arm or leg may feel warmer or cooler compared to the opposite limb. The skin on the affected limb may change color, becoming blotchy, blue, purple, pale, or red.

Other common features of CRPS include:

changes in skin texture on the affected area; it may appear shiny and thin

abnormal sweating pattern in the affected area or surrounding areas

changes in nail and hair growth patterns

stiffness in affected joints

problems coordinating muscle movement, with decreased ability to move the affected body part

abnormal movement in the affected limb, most often fixed abnormal posture (called dystonia) but also tremors in or jerking of the limb.

Types:
There are TWO TYPES OF CRPS

CRPS Type I , formerly known as RSDS, can follow a minor nerve injury, a simple trauma (fall or sprain), break or fracture (especially wrist and ankle), a sharp force injury (such as a knife or bullet wound), heart problems, infections, surgery, spinal injuries/disorders, RSI's (Repetitive Stress Injuries), CTS (Carpal Tunnel Syndrome), Tarsal Tunnel Syndrome, injections, and even some partial paralysis injury cases. There are some cases of CRPS Type I where there the nerve injury cannot be immediately identified. As many as 65% of CRPS/RSDS cases come from soft tissue injuries; such as burns, sprains, strains, tears, and most of the problems that end in “itis” ; bursitis, arthritis, and tendonitis to name a few.

New research done in 2006 by Dr Anne Louise Oaklander's team at Massachusetts General Hospital revealed the presence of small-fiber nerve damage in nearly all the CRPS Type I cases they studied. For more on this see question number 14 here

CRPS TYPE II, once known as CAUSALGIA, involves definable major nerve injury.

Early recognition of the disease, correct diagnosis, and proper treatment, are all essential in keeping CRPS from becoming a chronic condition. Treatment must begin within months of onset or significant probability of long-term disability occur. It is essential to find a CRPS-educated physican to ensure an early and correct diagnosis.

SYSTEMS AFECTED

Circulatory system

Digestive system

Endocrine system

Immune system

Integumentary system

Lymphatic system

Muscular system

Nervous system

Reproductive system

Respiratory system

Skeletal system

Urinary system

Symptoms

See above

Treatments

Treatment consists of interventions that manage pain and the other secondary issues caused by the disease including:

Pain and nerve medications

Antidepressants, beta-blockers, and other drugs like Naltrexone that offer reduced pain as a side effect

Nerve blocks (sympathetic, peripheral, and lumbar)

SPinal cord and Dorsal Root Ganglion (DRG) stimulation

Ketamine and Neridronate infusions

Alternative therapies

Specialist who treat it

Anaesthesiology Neurology Palliative Medicine/ Care Psychiatry Psychology Psychotherapy

Who can help you

RSD/CRPS Doesn't Own Me

RSD/CPRS Doesn't Own Me

Burning Nights CRPS Support

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