Complex Regional Pain Syndrome

Complex Regional Pain Syndrome (CRPS) formerly known as Reflex Sympathetic Dystrophy Syndrome (RSDS) is a very debilitating disorder that begins after nerve injury. The nerves become hypersensitive and pain is felt in situations that are not normally painful.

The cause of CRPS is not completely understood. It is thought to result from damage to the nervous system, including the nerves that control the blood vessels and sweat glands.

The damaged nerves are no longer able to properly control blood flow, sensation, and temperature to the affected area. This leads to medical problems in the nerves, blood vessels, skin, bones, and muscles.

This condition is more common in people between the ages of 40-60, but has been seen in younger people too.

Symptoms
In most cases CRPS has 3 stages. Often, however, CRPS does not follow this progression. Some people go into the later stages almost immediately. Others remain in Stage 1 indefinitely.
Stage 1 (lasts 1-3 months)

  • Severe burning, aching pain increasing with the slightest touch or breeze
  • Swelling with warmth or coolness
  • Skin becomes dry and thin, changes color
  • Increased nail and hair growth
  • Pain may move further up or down the affected limb

Stage 2 (lasts 3-6 months)

  • Swelling spreads
  • Noticeable changes in skin texture and color
  • Decreased hair growth
  • Changes in bone seen in X-rays
  • Stiff muscles and joints

Stage 3 (irreversible changes become evident)

  • Pain may exist in the entire limb
  • Permanent tissue changes
  • Muscle wasting
  • Limited mobility in limb
  • Contractions involving muscles and tendons

Treatment
Usually, the recommended treatment will include a combination of therapies. These will include:

  • Medications — pain medicines, steroids, blood pressure medicines that work on the sympathetic nervous system, bone loss medications (such as Actonel), and antidepressants
  • Physical or occupational therapy
  • Applications of heat and cold
  • The use of a TENS (trancutaneous electrical nerve stimulator) unit
  • Biofeedback
  • Nerve blocks (injecting medicine to numb the affected nerves or pain fibers around the spinal column)
  • Surgical sympathetomy (radical surgical that involves cutting the nerves to destroy the pain, but other sensations may be destroyed also)

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