In Chronic Pain, Pain Management

Chronic Regional Pain Syndrome is a severely debilitating and very painful condition. People who have the disease find it hard to bear even the slightest touch or feel any sensation in the affected area. So, what do you need to know about CRPS? Let’s find out.

What is Complex Regional Pain Syndrome?

Complex Regional Pain Syndrome (CRPS) is a chronic condition that affects one or more limbs’ nerves and soft tissues. It usually appears following an injury or trauma to the affected limb, but it can also develop for no apparent reason. CRPS often develops after surgery and causes intense burning pain, swelling, stiffness, and changes in skin color.

Types of CRPS

  • Type I:

Formerly called Reflex Sympathetic Dystrophy Syndrome (RSDS), usually starts with an injury to a limb and develops within six months. Type I CRPS is more common than type II and usually affects one limb at a time. In most cases, it involves the upper or lower limbs but affects the trunk (chest and abdomen).

  • Type II:

Formerly called causalgia, rarely occurs following an injury — it appears suddenly without any apparent cause. It is more common than type I, affecting both men and women equally and typically affecting more than one limb at once.

Symptoms

People with CRPS may experience:

  • Warmth or temperature sensitivity in the affected limb. This can range from mild warmth to severe burning sensations.
  • Sensitivity to touch or movement of the affected limb. For example, some people with CRPS may be hypersensitive to light touch, while others may experience allodynia, which means they have a heightened reaction to being touched.
  • Changes in skin color, including redness, mottling, and discoloration (darker than usual).
  • Changes in skin texture, including thickening and hardening of skin tissue.
  • Muscle spasms or twitching (fasciculations).

Causes of CRPS

CRPS can occur after an injury or trauma to the body. The condition usually develops within three months of the initial injury, but symptoms may not appear until months or years later.

The cause of CRPS is unknown, but some factors have been identified as contributing to its development. These include:

  • Traumatic injury: The most common cause of CRPS is an injury that affects the nerves or joints of the upper or lower limbs. A traumatic injury can be caused by a fall, crush injury, surgery, or even an injection into the joint.
  • Fractures: Fractures can injure nerves and blood vessels around joints, which increases the risk of developing CRPS.
  • Sprains or strains: Sprains and strains can damage ligaments and muscles surrounding joints, leading to increased pressure inside them (5). It can irritate surrounding tissues and increase the risk of developing CRPS.
  • Injections into the joint: Injections into joints (such as corticosteroids) may cause damage that triggers CRPS to develop months later.
  • Surgery: Surgery, including joint replacement surgery, dental surgery, and cosmetic surgery, can also trigger CRPS. These procedures can damage nerves that are close to the skin surface. The damaged nerve endings send pain signals to the brain, perceived as burning or throbbing pain.

Treatment Options

There is no cure for Complex Regional Pain Syndrome. Treatment focuses on pain management and physical therapy to help you regain strength, mobility, and function.

Medications:

  • NSAIDs (non-steroidal anti-inflammatory drugs) include ibuprofen, naproxen sodium, and celecoxib. These may be prescribed to help relieve some of the pain and swelling associated with CRPS.
  • Tricyclic antidepressants, such as amitriptyline and nortriptyline, may be used to relieve the pain and sleep disturbances that can occur with CRPS.

Physical therapy:

Physical therapy helps restore normal movement and strength to affected joints by using heat therapy, exercise, massage, and other techniques. It’s often used in combination with other treatments during the early stages of CRPS.

Cognitive-behavioral Therapy:

Secondary psychological disorders such as situational anxiety, depression, or post-traumatic stress disorder are common in individuals with severe CRPS. CBT teaches patients to recognize the thoughts and feelings that trigger their symptoms. It teaches them how to change these thoughts and feelings to reduce their pain.

Hopefully, you now better understand CRPS and who might be affected by it. If you or someone you know is suffering from CRPS, remember that there is help at Texas Pain Experts. We are dedicated to helping you work towards healing and managing symptoms.

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