What is Complex Regional Pain Syndrome (CRPS)?

Complex regional pain syndrome is a chronic disease which progresses over the period of time. It is involves swelling, changes in the skin and severe pain. Neither the cause nor the mechanism of the condition is understood yet.

The International Association for the Study of Pain classifies it primarily into two types, namely, Type I or reflex sympathetic dystrophy (RSD) and Type 2 or causalgia.

In the former case, no apparent signs of damage in the nerves are seen and in the latter, there are evidences of nerve injury. Though people from any age can get affected with it, women are three times more at risk than men.

The mean age of diagnosis is found to be around 42 years. Some of the observations with this condition are 13-70 percent patients have paralysis on one side of the body, 2-5 percent of them have injury in the nerves outside the brain and spinal cord. Smokers are also found to be at higher risk of developing this condition for some unknown reasons.

Symptoms of Complex Regional Pain Syndrome (CRPS):
If the signs of this condition are identified within three months of their appearance, then there are very good chances of it getting treated. Delay in commencement of the treatment or ignoring of the signs can lead to disorder spreading quickly to the entire limb, causing changes in bone, nerve and muscle.

In this way, the condition can become irreversible. This calls for awareness of the signs of CRPS. Some general signs are:

  • Burning sensations in the site of injury
  • Electrical sensations in the form of shooting pain
  • Abnormally increased sweating
  • Muscle spams
  • Local swelling
  • Softening and thinning of bones
  • Changes in skin color and temperature
  • Stiffness
  • Tenderness in joints
  • Painful and restricted movements of limbs
  • Continuous pain leading to physical or emotional stress

The severity and duration of these above mentioned signs vary from person to person. The types and their associated body signs are:

Type 1 Symptoms:

  • Severe burning pain at the injury site
  • Joint stiffness
  • Muscle spasm
  • Restricted mobility
  • Narrowing of blood vessels
  • Rapid hair
  • Nail growth
  • Changes in skin color
  • Changes in skin temperature of the skin

Type 2 Symptoms:

  • Intense pain
  • Spreading of swelling
  • Cracked, grooved, spotty and brittle nails
  • Diminished hair growth
  • Thickening of joints
  • Severe osteoporosis
  • Muscles atrophy

Type 3 Symptoms:

  • Irreversible changes in the bones and skin and bones
  • Pain in the entire limb
  • Severe restrictions in the movement of affected organs
  • Marked muscle atrophy
  • Contractions of the muscles and tendons that flex the joints
  • Displacements of limbs from their normal positions occasionally
  • Thinning and softening of bone significantly

Diagnosis of Complex Regional Pain Syndrome (CRPS): It is complicated process because there is no one single test by which this condition can be confirmed after observing the symptoms. Moreover, some people show improvement even without a treatment. But in most of the cases, early diagnosis is imperative to getting better results of the treatment.

According to the International Association for the Study of Pain (IASP),

The Diagnostic Criteria for Type 1 CRPS are:

  • An event causing injury to the body or immobilization
  • Continuing pain
  • Hyperalgesia – notion of extreme pain
  • Allodynia – Perception of pain even from a nonpainful stimulus
  • Edema
  • Changes in skin blood flow in the area of pain
  • If another cause is found for pain and dysfunction, then Type 1 CRPS is excluded

The Diagnostic Criteria for Type 2 CRPS are:

  • Presence of continuing pain
  • Hyperalgesia after a nerve injury
  • Allodynia feeling in other parts of the body too
  • Changes in skin blood flow
  • Edema
  • If another cause is found for pain and dysfunction, then Type 2 CRPS is excluded

Thermography is a tool used to find the flow of blood in the injury area along with the temperature in that site. Abnormal sweating can be tested using color changing powder in the presence of sweat. Radiography reveals any changes in the conditions of the bones. Electrodiagnostic testing finds out signs of nerve injury.

Treatment of Complex Regional Pain Syndrome (CRPS):
A daily dose of 500 mg of Vitamin C is recommended for preventing this condition. In general, the approach to deal with CRPS is many pronged apart from the medicines prescribed the doctors. Some of the available treatment options are:

  • Mirror box therapy
  • Physical and occupational therapy
  • Tactile discrimination training
  • Graded motor imagery
  • Local anaesthetic blocks/injections
  • Graded exposure to fearful activities
  • Sympathectomy
  • Spinal cord stimulators
  • Ketamine – a powerful pain relieving drug
  • Collateral meridian therapy

1 response to What is Complex Regional Pain Syndrome (CRPS)?

  1. can people die from it?
    i’m worried!

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