Complex Regional Pain Syndrome (CRPS): Causes, Symptoms, and Treatments

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Complex regional pain syndrome is a chronic health condition that causes long-term pain and inflammation. It usually occurs after a heart attack, stroke, surgery, or an injury and primarily affects the legs or arms.

The pain in complex regional pain syndrome (CRPS) does not reduce with time but increases, unlike other medical conditions. The cause of CRPS is not clearly understood, and only a few people have been diagnosed with this condition. But it’s believed to occur due to a central nervous system abnormality or injury.

 There are two types of CRPS, and both have different causes but similar symptoms:

  • CRPS I: This type is also called reflex sympathetic dystrophy (RSD), and it occurs after an injury or sickness that didn’t directly damage the nerves in the limb you’re feeling pain.
  • CRPS II (causalgia): It occurs after a severe injury that affects the nerves in the limb you feel the pain.

How To Know If You Have Complex Regional Pain Syndrome (CRPS)?

There is no specific test to diagnose CRPS. Still, your doctor can rule out other diseases that could cause pain similar to what you’re experiencing to confirm a diagnosis. Typically, they discuss your medical history, physically examine you, and run other tests like bone scans, MRI, and x-rays in the process.

Your doctor can also recommend a sympathetic nerve block to find out the origin of the pain. It involves injecting an anesthetic near the spine to block the sympathetic nerves in the affected area of the body. Although CRPS can affect anyone regardless of gender, it is more common in women.

The most common sign of CPRS is pain. It might occur spontaneously, without any stimulation, or after a traumatic event or injury such as a fracture, sprain, or minor surgery. Even after the injury heals, the pain remains and worsens over time. It could get to the point where a mild touch or a shower can incite the pain.

Other signs of CRPS are:

  • Highly sensitive skin
  • Burning sensation in the affected area
  • Abnormal nail or hair growth; there may be rapid hair and nail growth on the affected limb or no growth at all.
  • Abnormal skin temperature changes, with the affected area being cooler or warmer than the other parts of the body
  • Skin color changes, usually blotchy, red, pale, or purple
  • Swelling in the affected area
  • Stiffness and difficulty in moving the affected joints
  • Abnormal sweating; there may be profuse sweating in patches of the affected body part or no sweating.

How to Treat Complex Regional Pain Syndrome (CRPS)   

There is no definite cure for complex regional pain syndrome, but there are various treatment options that can help manage the symptoms. In many cases, people suffering from CRPS experience a gradual reduction in their pain.

Some others continue experiencing pain despite the treatment. In such cases, your doctor might recommend a different therapy or combination of treatments to manage the pain. Generally, it is advisable to opt for a CRPS treatment plan since it can increase your chances of recovery and reduce the rate that the condition progresses.

CRPS can lead to tissue wasting, also known as atrophy, if left untreated. In atrophy, the bones, skin, and muscles begin to weaken and deteriorate, causing difficulty moving the affected arm or leg due to pain. Untreated CRPS can also cause muscle tightening, also called contracture, making the muscles in the affected limb contract into a fixed position. If that happens, you’ll be unable to move your hands or feet.

The treatment options for CRPS include the following:

Pain Relief Medication

Your doctor can recommend various pain relief medications to help treat CRPS and reduce the spread of the pain. Typically, doctors start by administering lower-strength painkillers before opting for stronger ones if there is no improvement in your condition. Common pain relief medicines used in managing CRPS are NSAIDs and opioids.

Over-the-counter NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen are often the first line of treatment for CRPS. Apart from helping with the pain, they reduce inflammation and other symptoms associated with the condition. Your doctor may recommend opioids like codeine and morphine for more severe pain. Anticonvulsants like gabapentin and tricyclic antidepressants such as amitriptyline have also been effective against CRPS pain.     

Physical Rehabilitation

CRPS can severely affect your limbs and make you unable to use them properly. Physical rehabilitation can help you regain use of your limbs without worsening the pain. Your doctor may recommend specific exercises like mild stretches, hydrotherapy, or light weight lifting.

You need maximum support from your therapist to avoid worsening the pain with vigorous exercise. Your doctor may also recommend desensitization therapy or CRPS alternative treatments like those offered in the Spero Clinic to increase your physical activity.

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