Complex Regional Pain Syndrome (CRPS), previously called Reflex Sympathetic Dystrophy (RSD), is a condition that generally affects arms and legs. CRPS/RSD can cause significant aching and burning pain in the arms or legs and may cause the limb to swell or feel hot or cold. In addition, the skin on the arm or leg may change texture and color or become thin and shiny. There also may be noticeable hair pattern changes (rapid hair growth or loss of hair), as well as increased sweating in the area of pain.
The symptoms in CRPS/RSD can vary in their severity and duration. Pain can become continuous and intense over a period of time. If CRPS develops after an injury, the pain seems more intense or out of proportion to the severity of injury. CRPS/RSD pain symptoms can also spread from the original site of injury to encompass the entire arm or leg. Pain can also be seen to affect the opposite extremity as well. Emotional stress can also cause the pain to worsen. Typical symptoms of CRPS/RSD include:
CRPS/RSD likely occurs from multiple factors producing the above symptoms. It often occurs after forceful trauma to a limb, such as a fracture, amputation or crush injury. Other “traumas” to the body can also cause CRPS whether it is major or minor including; surgery, heart attacks, infections and sprains. Emotional stress can also bring about or aggravate CRPS. It is not currently know why and exactly how CRPS is triggered but it is believed that there is a dysfunction in the nervous system causing inappropriate response and inflammation. Another thought is that it may be caused by an immune response and healing process that has become disrupted and abnormal causing symptoms of swelling, warmth and redness in the affected area.
There are two types of CRPS for which patients seek RSD relief, each having similar signs and symptoms, but different causes. CRPS Type 1 occurs after an illness or injury without a known, direct damage to nerves in the affected limb. It is believed that the pain receptors in these patients become very sensitive to catecholamines, chemicals that work as messengers in the nervous system and are associated with the sympathetic limb of the nervous system often called the “fight or flight” system. CRPS Type 2 occurs after a distinct nerve injury. Most patients, estimated to be around 90% of people, have CRPS Type 1.
It is important that CRPS is diagnosed and treated early; otherwise it could progress to become more disabling. Symptoms of CRPS include atrophy (loss of muscle mass), or tissue wasting and contracture, or muscle tightening. Once an affected limb becomes cold, pale and undergoes skin and nail changes and decreased mobility due to muscle spasms and tightening, the condition is often irreversible. It is important that patients seek RSD pain treatment and care in a timely manner, as RSD treatment is most effective when started early in the course of this condition.
No single test can diagnose CRPS. A physical exam and a medical history will be the first step of diagnosis, followed by procedures that may provide insight. Some of these procedures include a bone scan, sympathetic nervous system test, x-rays and MRI.
As with many conditions, if CRPS is treated in the early stages it can be treated much more effectively than if left for long periods of time untreated. Various medications can be used for CRPS/RSD pain relief, including pain relievers, corticosteroids, bone-loss medication and sympathetic nerve-blocking medication. Hot and cold applications to the site and topical analgesics can be done at home, and physical therapy may be suggested to maintain limb mobility and desensitization therapy. There are a number of treatment options for CRPS/RSD relief, which include:
At MAPS we value the importance of an interdisciplinary approach. For those CRPS/RSD treatments not offered by MAPS, we are able to refer you to other CRPS/RSD pain relief treatment specialists.