Complex Regional Pain Syndrome (CRPS)
What is CRPS?
Complex regional pain syndrome is a painful and disabling condition. It is defined as chronic pain that lasts more than six months. It affects a single limb, an arm, leg, hand or foot. The hallmarks of CRPS are pain and mobility issues that are out of proportion to the precipitating injury or trauma.
Who is at risk for CRPS?
CPRS can affect anyone but is most common in women around age 40. It is also called Reflex Sympathetic Dystrophy Syndrome or RSDS. CRPS is rare. Symptoms can be improved and even remit with early treatment. Most patients improve slowly over time.
What are the symptoms of CRPS?
Patients with CRPS display varied symptoms. Patients do not have to show all these symptoms to receive a diagnosis of CRPS.
- Prolonged or excessive pain that develops long after an injury has healed.
- Pain that can be described as burning, pins and needles or a squeezing sensation.
- The pain may spread from the injured area to the entire limb e.g. a toe injury can cause chronic pain in the entire leg.
- The affected limb may feel hot or cold when compare to the opposite limb. Changes in skin temperature and color are due to abnormal microcirculation caused by damage to the nerves that control blood flow and temperature.
- Edema (swelling) may be diffuse or localized.
- Increased skin sensitivity, called allodynia, that makes wearing clothes or using bed sheets and covers intolerable.
- Swollen and stiff joints in the affected limb and loss of mobility.
- Muscle pain and weakness.
- Abnormal limb movements including tremors and jerking.
- Rashes, ulcers and pustules are common skin disorders
- Problems with muscle coordination and difficulty moving the affected limb.
Symptoms can be mild and last for weeks and then remit. However, in most cases the pain continues for years with periods of remission and exacerbation. CPRS can be a cause of long-term disability.
What causes CPRS?
The cause is unknown but is believed to be a malfunction of the nervous system or damage to the nervous system. 90% of cases of CRPS involve a history of trauma or injury that is believed to cause damage to the nervous system. Research reports that the most common cause of CRPS is a fracture and cast immobilization. Common triggers are fracture, sprain, strain, burn, cut, bruise, surgery and minor insults like a needle stick. Other precipitating factors include heart attack, spinal disorders, infections, and repetitive trauma as in carpal tunnel syndrome. However, in some cases a precipitating event cannot be found.
CRPS also triggers the body’s immune response and causes inflammation. CPRS is more common in people with inflammatory and autoimmune conditions such as asthma. There is limited information on the genetic risk. Often CRPS can have multiple causes.
How is CPRS diagnosed?
Your Ortho Illinois doctor will ask about your pain symptoms and any recent injuries. They will conduct a physical exam. Imaging studies may be recommended to confirm the diagnosis.
Testing may be directed to eliminating conditions that cause similar symptoms such as Lyme disease, arthritis, and other muscle diseases.
CRPS is often associated with bone loss seen in osteopenia and osteoporosis and other diseases that cause increased bone resorption. CRPS may also be part of another disease process.
At Ortho Illinois our specialists will work with you to assess all alternative disorders that produce some of the features of this syndrome. Once we have a full view of your condition, we will create a personalized treatment plan to safely and effectively treat all of your symptoms and rehabilitate you in the shortest time possible.
How is CRPS treated?
Treatment is focused on pain relief, include pain medications, physical therapy and nerve blocks. Mental heath disorders like anxiety and depression are common and can exacerbate pain. Psychological therapy can help patients cope.
Ortho Illinois is a multi-specialty practice dedicated to educating CRPS patients about their conditions and employing all modalities available to us to facilitate your return to the life you love.
