Complex Regional Pain Syndrome

What is Complex Regional Pain Syndrome?

Complex Regional Pain Syndrome (CRPS) is chronic arm or leg pain developing after an injury, surgery, stroke, or heart attack. The exact cause of complex regional pain syndrome isn’t well understood, but may involve abnormal inflammation or nerve dysfunction. The main characteristic of CRPS is pain that is greater than expected from the injury that causes it. Treatment usually consists of medications, heat or cold therapy, physical therapy, and biofeedback.

What Are The Symptoms?

The main characteristic of CRPS is pain that is greater than expected from the injury that causes it.

Pain areas include: arms or legs, back (can be chronic), feet, hands, or in the nerves. It is Possible for the muscle to be affected in the pain area as well, these symptoms include loss of muscle, muscle spasms, or rhythmic muscle contractions.

There can be redness, stiffness, swelling, or tenderness of the limb affected by CRPS. CRPS can have sensory symptoms as well. These include: the feeling of pins and needles, the affected area can be sensitive to pain or have uncomfortable tingling and burning sensations. Often times depression can accompany the diagnosis of CRPS.

What Are The Causes of CRPS?

The cause of CRPS isn’t completely understood. It’s cause is thought to be by an injury or an abnormality of the peripheral and central nervous systems. CRPS typically occurs as a result of a trauma or an injury.

CRPS occurs in two types, with similar signs and symptoms, but different causes:

  • Type 1. Also known as reflex sympathetic dystrophy syndrome (RSD), this type occurs after an illness or injury that didn’t directly damage the nerves in your affected limb. About 90 percent of people with complex regional pain syndrome have type 1.
  • Type 2. Once referred to as causalgia. This type has similar symptoms to type 1. But type 2 complex regional pain syndrome follows a distinct nerve injury.

Many cases of CRPS syndrome occur after a forceful trauma to an arm or a leg. This can include a crushing injury, fracture or amputation.

Other major and minor traumas — such as surgery, heart attacks, infections and even sprained ankles — can also lead to CRP syndrome.

It’s not well-understood why these injuries can trigger CRPS. Not everyone who has such an injury will go on to develop this syndrome. It might be due to a dysfunctional interaction between your central and peripheral nervous systems, and inappropriate inflammatory responses.

What Are The Treatments of CRPS?

Treatment consists of self care such as using a heating pad.

Therapies include biofeedback, physical therapy, and acupuncture.

Medications include:

  • Antihypertensive drug
  • Nerve pain medication
  • Muscle relaxant
  • Sedative
  • Anesthetic
  • Narcotics 

Medical procedures include nerve blocks, stellate ganglion blocks,  and Bier blocks.

Nerve blocks and steroid shots. The nerve block that your doctor might do to diagnose your condition can be a short-term treatment, too. It may take two to three shots over several weeks to get control of your pain. It’s not uncommon for the problem to return at some point, requiring another series of injections.