Complex Regional Pain Syndrome (CRPS)

Complex Regional Pain Syndrome

Complex regional pain syndrome (CRPS) is a nerve disorder that causes long-lasting (chronic) pain, usually in a hand, arm, leg, or foot. CRPS usually follows an injury or trauma, such as a fracture or sprain.

There are two types of CRPS:

Type 1. This type occurs after an injury or trauma with no known damage to a nerve.

Type 2. This type occurs after injury or trauma damages a nerve.

There are three stages of the condition:

Stage 1. This stage, called the acute stage, may last for three months.

Stage 2. This stage, called the dystrophic stage, may last for three to 12 months.

Stage 3. This stage, called the atrophic stage, may start after one year.

CRPS ranges from mild to severe.

For most people CRPS is mild and recovery happens over time. For others, CRPS lasts a very long time and is debilitating.
CAUSES

The exact cause of CRPS is not known.
RISK FACTORS

You may be at increased risk if you:

Are a woman.

Are about age 40.

Have any of the following:

A family history of CRPS.

An injury or surgery.

An infection.

Cancer.

Neck problems.

A stroke.

A heart attack.

Asthma.

SIGNS AND SYMPTOMS

Signs and symptoms in the affected limb are different for each stage. Signs and symptoms of stage 1 include:

Burning pain.

A pins and needles sensation.

Very sensitive skin.

Swelling.

Joint stiffness.

Warmth and redness.

Excessive sweating.

Hair and nail growth that is faster than normal.

Signs and symptoms of stage 2 include:

Spreading of pain to the whole limb.

Increased skin sensitivity.

Increased swelling and stiffness.

Coolness of the skin.

Blue discoloration of skin.

Loss of skin wrinkles

Brittle fingernails.

Signs and symptoms of stage 3 include:

Pain that spreads to other areas of the body but becomes less severe.

More stiffness, leading to loss of motion.

Skin that is pale, dry, shiny, and tightly stretched.

DIAGNOSIS

There is no test to diagnose CRPS. Your health care provider will make a diagnosis based on your signs and symptoms and a physical exam. The exam may include tests to rule out other possible causes of your symptoms. Sometimes imaging tests are done, such as an MRI or bone scan. They check for bone changes that might indicate CRPS.
TREATMENT

Early treatment may prevent CRPS from advancing past stage. There is no one treatment that works for everyone. Treatment options may include:

Medicines, such as:

Nonsteroidal-anti-inflammatory drugs (NSAIDS).

Steroids.

Blood pressure drugs.

Antidepressants.

Anti-seizure drugs.

Pain relievers.

Exercise.

Occupational and physical therapy.

Biofeedback.

Mental health counseling.

Numbing injections.

Spinal surgery to implant a spinal cord stimulator or a pain pump.

HOME CARE INSTRUCTIONS

Take medicines only as directed by your health care provider.

Follow an exercise program as directed by your health care provider.

Maintain a healthy weight.

Keep all follow-up visits as directed by your health care provider. This is important.

SEEK MEDICAL CARE IF:

Your symptoms change.

Your symptoms get worse.

You develop anxiety or depression.

CRPS usually follows an injury or trauma, such as a fracture or sprain.T
Take medicines only as directed by your health care provider.T
Maintain a healthy weight.T
The exact cause of CRPS is known.