Complex Regional Pain Syndrome
Formerly called reflex sympathetic dystrophy (RSD), complex regional pain syndrome (CRPS) is a type of chronic pain syndrome that causes severe burning pain in an arm or leg. The earlier the condition is identified and treatment is begun, the better the outcomes. If left untreated, CPRS can cause irreversible deterioration of the affected arm or leg.
There are two types of CRPS. Type 1, which affects about 90 percent of people with CRPS, is also known as reflex sympathetic dystrophy syndrome. It occurs after an illness or injury that didn't directly damage the nerves in the affected extremity. Type 2, also known as causalgia, follows a distinct nerve injury.
What Causes CRPS?
While the exact cause of CRPS is unknown, it tends to develop following an injury, surgery, stroke, or heart attack, yet with pain that is out of proportion to the severity of the initial injury.
Researchers suspect that changes in the sympathetic nervous system lead to poor regulation of blood flow, sensation, and temperature, which contributes to problems involving the skin, nerves, blood vessels, bones, and muscles.
What Are the Symptoms of CRPS?
The symptoms of CRPS vary from person to person. Severe burning pain, joint stiffness, and swelling are hallmark symptoms of CRPS.
Other symptoms may include:
- Sensitivity to touch or cold
- Changes in skin temperature, color, and/or texture
- Changes in hair and nail growth
- Muscle spasms, weakness, and atrophy
- Decreased ability to move the affected body part
These symptoms typically occur in three stages. However, not all people progress through all three stages; some may stay in the first stage indefinitely while others may skip a stage.
Stage 1 occurs at the onset of CRPS and can last about three months. You may feel burning pain, stiffness, increased sweating, and warmth in your affected limb. Your nails and hair may grow faster than usual. Your skin may become dry, thin, and change color.
Stage 2 CRPS lasts from three to twelve months. You may experience an increase in swelling. Your skin may become cooler and more sensitive to touch. Your pain may become more widespread. Your joints and muscles may become stiffer.
Stage 3 occurs from one year on. Changes in this stage may be irreversible and permanent. The pain may spread to your entire limb. Your joints may be very stiff and difficult to move. You may experience muscle wasting and contractures.
How Do You Treat CRPS?
While there is no cure for CPRS, early treatment can prevent the disease from progressing and, in some cases, even prompt remission. Treatment goals during the advanced stages are aimed at symptom relief and improving function.
You may need more than one treatment to address the varying symptoms. Your doctor can prescribe a combination of medications to help ease your symptoms, including pain relievers, antidepressants, anticonvulsants, and steroids.
Injected pain-relieving medications, ketamine infusion, nerve blocks, spinal cord stimulation, dorsal root ganglion stimulation, and implanted medication delivery pumps may provide pain relief for longer periods of time.
Physical therapy can also help decrease pain and improve range of motion in the affected arm or leg. Your therapist may use modalities such as heat and cold therapy or a transcutaneous electrical stimulation (TENS) unit. Desensitization techniques may be helpful for hypersensitivity.
To learn more about CRPS and the treatments we provide or to schedule a consultation with one of our pain management doctors, please call Chicagoland Pain Management in Bolingbrook, IL at (630) 312-4505 or in Hinsdale, IL at (630) 856-6825 or use our convenient online appointment request form.
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