Complex regional pain syndrome (CRPS) is a chronic pain condition that affects one of the following limbs: feet, legs, hands or arms, most likely after an injury or trauma to that limb. It is believed that this condition can be caused by a malfunction or damage to the nervous systems. The hallmark signs of CRPS are excessive pain, changes in skin color, temperature or swelling of the affected limb.
There are two forms of CRPS. CRPS-I occurs in individuals without nerve damage, which was previously known as Reflex sympathetic dystrophy syndrome (RSD). The other, CRPS-II is associated with nerve damage and was once referred to as causalgia, which is severe burning pain in a limb caused by injury to a peripheral nerve.
CRPS can happen in anyone, although it is more common in females and at an average age of 40. It typically is not seen in children under the age of 5 and it is not common in the elderly.
Mechanism of Injury
Symptoms
The most noticeable symptom of CRPS is prolonged pain that can feel like “pins and needles” or a burning sensation that can spread through the entire limb. There is also the presence of increased sensitivity to the affected area even with light touch. Changes in temperature, skin color and swelling of the affected area may also be present. This is due to the damage of the nerves that control blood flow and temperature leading to a change in blood circulation.
Other symptoms:
- Stiffness of the affected joint
- Changes in skin texture (shiny or thin)
- Abnormal sweating patterns of the affected limb and/or surrounding areas
- Poor coordination of muscle movements in the affected limb
- Fixed posture or abnormal movement of the affected limb
- Jerking or tremors of the affected limb
- Changes in the growth patterns of hair and nails
The main focus is to be able to identify the symptoms of this condition before the damage to the nerves lead to sensory deficits.
Diagnosis
CRPS is a challenge to diagnose. The diagnosis is usually based on a detailed history and the signs and symptoms associated with this condition. Testing can be done to rule out other conditions that have similar signs and symptoms such as Lyme disease, clotted veins, arthritis or other condition most associated with diabetes.
The use of bone scans or magnetic resonance imaging (MRI) are useful tests to help diagnose a few of the characteristic changes associated with CRPS.
Treatment
There are many forms of treatment for CRPS including: rehabilitation therapy, medication, sympathetic nerve block and spinal cord stimulation just to name a few.
Some studies suggest that a sympathetic nerve block gives temporary relief as it helps to promote blood flow. This is also true of rehabilitation therapy. Incorporating an exercise program tailored by our doctors at Back to Function will keep the affected limb moving, which helps improve blood flow, flexibility, function and strength. At Back to Function, the rehabilitation programs are customized for the individual, which is highly important for those suffering from CRPS. Providing that the diagnosis is made early is key in preventing this condition from becoming chronic and debilitating.
