Complex Regional Pain Syndrome (CRPS)

What is complex regional pain syndrome (CRPS)?

Complex regional pain syndrome (CRPS) is a type of chronic pain (lasting more than 6 months). It is uncommon and typically affects one or more limbs such as an arm, leg, hand, or foot, but it can affect other parts of the body as well. The syndrome usually starts after one experiences an injury, has a stroke, heart attack, surgery, or other major/minor traumatic event. The pain that they experience after these events is out of proportion to the severity of the originating event, however.
 
People with CRPS typically experience extreme, prolonged pain, changes in skin color, changes in temperature, and/or redness and swelling/sensitivity of the affected area. Severity and duration of this condition may vary from person to person. In some people, the condition is mild and goes away eventually. In more severe cases it may get worse over time, spread to other body parts, and/or cause people to suffer from long-term disability. 
 
It is thought that CRPS is caused by damage and/or malfunction of the peripheral and central nervous systems. The central nervous system (CNS) is the brain and spinal cord, while the peripheral nervous system (PNS) are the nerves that makeup the rest of the body. 
 
There are two types of CRPS:
 
  • CRPS-I: People who don’t have a diagnosed nerve injury but suffer from CRPS, are considered to have CRPS-I (formerly known as reflex sympathetic dystrophy syndrome
  • CRPS-II: People who have a confirmed nerve injury that is associated with their CRPS are considered to have CRPS-II (formerly known as causalgia). 
 
 
Risk factors
 
  • Gender: CRPS is more common in women. 
  • Age: Although this condition can occur at any age, it is much less common in the elderly and children under age 10. The peak age for CRPS is age 40. 
  • Emotional stress
  • Forceful trauma to a limb
  • Major/minor traumas such as surgeries, infections, heart attacks, sprains, fractures, burns, cuts, even needle sticks, can all be triggers for CRPS.
 
 
Diagnosis 
When diagnosing CRPS, your doctor will likely do a complete medical history and exam. The doctor will pay close attention to your signs and symptoms and may do tests to rule out other conditions. There is not one specific test that is used to diagnose CRPS.
 
Some tests that may be done in order to diagnose CRPS include:
 
  • X-rays: In later stages of CRPS, loss of minerals from your bones may be seen in an X-ray. 
  • Magnetic resonance imaging (MRI): Tissue changes may be visible in an MRI.
  • Sympathetic nervous system tests: These tests are used to detect changes/disturbances in the sympathetic nervous system. Thermography is a test that measures skin temperature and blood flow in the limbs affected by CRPS and the unaffected limbs as well. There are other sympathetic nervous system tests that measure and compare the amount of sweat on affected and unaffected limbs. If the results differ between the limbs, this could mean CRPS. 
  • Bone scan: This test can be used to look for any changes in your bones. During the test, a radioactive substance is injected into your veins so the doctor can look at your bones. 
 
 
Treatment
With proper treatment within the first few months of symptom onset, people with CRPS may be able to see great improvement in their symptoms and maybe even achieve remission. Treatment can vary from person to person and often includes multiple therapies. 
 
Possible treatments for CRPS include:
 
  • Pain relievers
  • Antidepressants
  • Anticonvulsants
  • Corticosteroids
  • Sympathetic nerve blocking medication
  • Bone loss medications
  • Topical analgesics
  • Physical therapy
  • Hot and cold application
  • Transcutaneous electrical nerve stimulation (TENS)
  • Spinal cord stimulation
  • Biofeedback
  • Intrathecal drug pumps
  • Psychotherapy
  • Surgical sympathectomy 
 
 
 
# COMPLEX REGIONAL PAIN SYNDROME (CRPS) BY THE NUMBERS #
  • In 70% of people with CRPS, the condition spreads to other parts of the body
  • 75% of people suffering from CRPS are women
  • Approximately 200,000 people in the United States suffer from CRPS 
  • In 8-10% of cases, the condition becomes systemic (body-wide)
  • Approximately 90% of CRPS cases are type I
 
about complex regional pain syndrome (CRPS)
 
 

Sources:
  • "Complex regional pain syndrome." Mayo Clinic. Mayo Foundation for Medical Education and Research, 12 Apr. 2014. Web. 13 Sep. 2017.
  • “Complex Regional Pain Syndrome Fact Sheet.” National Institutes of Health. National Institutes of Neurological Disorders and Stroke, n.d. Web. 13 Sep. 2017. 
  • “Complex Regional Pain Syndrome.” National Institutes of Health U.S. National Library of Medicine. MedlinePlus, n.d. Web. 13 Sep. 2017. 
  • “CRPS Overview/Description.” American RSDHope, 2017. Web. 13 Sep. 2017. 
  • “Complex Regional Pain Syndrome.” American Academy of Family Physicians. familydoctor.org, Jul. 2017. Web. 13 Sep. 2017.  

 

 

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