Complex regional pain syndrome (CRPS) is a pain problem manifested by severe pain. It is a poorly understood disorder that causes intense pain.
With CRPS, the nervous system becomes hyper sensitized – normal sensations become amplified. The thermostat for pain sensitivity becomes set at the wrong level. The sympathetic autonomic nervous system also becomes hyperactive. This combination of problems leads to severe pain in the affected area, often a hand or foot.
2 Types of CRPS
There are two basic types of CRPS:
- Type I occurs with no known nerve injury
- Type II occurs in association with a known nerve injury
CRPS describes an array of painful conditions characterized by regional symptoms seemingly disproportionate to the usual course of trauma or injury. The pain is regional, not in a specific nerve or muscle distribution. The patient will report sensory changes such as:
- Hyperesthesia
- Changes in skin color
- Edema and temperature changes
- Motor changes – inability to move the affected region
It usually begins in one limb, often diagnosed months after onset, and is 3 times more common in females. The initial injury is usually minor, such as an ankle sprain. Because of this, there is often a delay in finding an expert who recognizes the diagnosis and can initiate treatment.
How to Treat CRPS
Treatment of CRPS is difficult, but should be done in four steps:
- The first step is evaluating and treating any treatable injuries that contribute to the pain. This may include surgical interventions for injuries such as ankle sprains.
- The second aspect is controlling the sympathetic aspects of pain and the neuropathic pain with injections and medications.
- The third part is rehabilitation and physical therapy, restoring mobility and decreasing pain sensitivity.
- The last part is psychology to use cognitive strategies to control central pain perceptions.
Complex regional pain can be devastating. The earlier it is diagnosed, the better the prognosis. Experienced pain management physicians are essential in improving the outcome. It can be successfully treated and there are many good interventions available. Find an experienced Pain physician, and find a solution.