[Synonyms of complex regional pain syndrome (CRPS) are reflex sympathetic dystrophy, reflex neurovascular dystrophy (RND), causalgia, algoneurodystrophy, sympathetically maintained pain, clenched fist syndrome, Sudek's syndrome, deafferentation Pain, amplified musculoskeletal pain syndrome (AMPS)]
What is complex regional pain syndrome (CRPS)?
Complex regional pain syndrome (CRPS) is when you have severe burning type of pain, skin color changes (reddish or bluish) and mild swelling in your body extremities — usually an hand or foot.
CRPS happens because something is wrong with your nerves. The problem makes your nerve system to react too much to pain signals and not stop.
CRPS has two subtypes:
Type I: When there is no reason for the starting of this disease.
Type II: This type is when it started after an event which may have caused a nerve damage (stroke, Fracture).
How common is complex regional pain syndrome (CRPS)?
It is a uncommon disease.
What are the symptoms of CRPS?
People with complex regional pain syndrome (CRPS) have different levels and lengths of symptoms.
CRPS symptoms usually begin four to six weeks after you hurt yourself, break a bone or have surgery. But sometimes they start for no reason.
Pain is the main symptom of CRPS. The pain can be always or sometimes there and feel like burning, stinging or tearing. It is often deep in your limb.
You may also have some specific characteristics in your pain, such as:
More pain from things that hurt (a pinch may feel worse than normal).
Pain from things that don’t hurt (like touching your skin).
No feeling.
Other symptoms of CRPS (other than pain) are:
Skin swelling: Swelling can stay or go away.
Less function in your limb: You may have trouble moving your limb or feel stiff. It may also be hard to put pressure on your limb or joint.
Skin temperature changes: The skin on your limb may be warmer or cooler than the other one.
Skin color changes: Your skin may look spotty, pale, purple/bruised or red.
Skin texture changes: Your skin may be shiny and thin or very sweaty.
Nail and hair growth changes: Your hair or nails may grow fast or not at all.
What are the causes of CRPS?
Some people get CRPS after an injury, but others don’t. Researchers think it’s because of an inflammation or immune response in your nervous systems.
CRPS usually comes from nerve damage in the limb that was hurt. The thinnest nerve fibers get damaged.
The most common precipitating factors are fracture (wrist and ankle) and stroke.
Other ways to get CRPS are surgery, sprains or strains, burns, bruises, or cuts.
CRPS is also more common in people with other diseases that cause inflammation or immune problems, like asthma.
Genetics: Your genes can change how you heal from an injury. Researchers have found families with CRPS. This is rare, but it means that CRPS may have a genetic link.
Prevention and Management
The aim of treatment is to
lower your pain and other problems,
make your limb work better and keep your life quality.
You need to start treatment from a Pain Clinic soon after you get CRPS. This is because CRPS can make your limb harden over time. Also, the pain usually gets worse without treatment, and it becomes harder to fix. Treatment consists of multiple modalities delivered by different speciality people. These modalities are: 1. Physical therapy and occupational therapy 2. Lifestyle changes 3. Psychosocial and behavioural therapy 4. Medicines 5. Pain interventions
Pain Interventions
1. Radiofrequency ablation of stellate ganglion or lumber sympathetic plexus as indicated.
2. Systemic desensitization
3. Spinal cord stimulation, Peripheral nerve stimulation, DRG stimulation
Other options
1. Graded motor imagery
2. Mirror therapy
3. Psychosocial and behavioural therapy
4. Acupuncture/ Biofeedback
You can always contact Dr Chinmoy Roy at Rajarhat Pain Clinic, Newtown, Kolkata for a complete treatment of CRPS.
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