Complex regional pain syndrome (CRPS) is a chronic pain disorder that occurs in a part of the body that has been injured or damaged.
The location is usually the arm or leg, but CRPS can occur anywhere. The resulting pain is often longer in duration or greater in intensity than what would usually be expected for a level of injury. CRPS often occurs after trauma or surgery. The cause is often disproportionate response of the sympathetic nervous system to fractures, crush injuries, sprains, or surgery. However, in about 10% of patients, there is no specific incident that causes CRPS.
CRPS has two subtypes, Type I and Type II.
- Type I (also known as reflex sympathetic dystrophy) includes patients who do not have damage to their peripheral nerves. Peripheral nerves transmit information from the brain and spinal cord to different parts of the body, and vice versa.
- Type II (also known as causalgia) occurs in patients who have peripheral nerve damage.
Symptoms of CRPS include:
- Burning, stinging, or tearing pain
- Changes in sensation (abnormally increased sensitivity or tenderness)
- Reduced strength in the affected part of the body
- Differences in skin temperature, skin color, sweat, or swelling
A diagnosis of CRPS is suspected when:
- The aforementioned symptoms develop after limb trauma, usually within 4-6 weeks
- Symptoms are disproportionate to the initial trauma (persist longer, or are more intense than is typical)
- Symptoms “travel” beyond the region involved in the trauma
At Unique Pain Medicine, we treat CRPS via:
- Sympathetic nerve blocks, which work by blocking the pathological signals being sent from the sympathetic nervous system to the affected part of the body.
- Trigger point injections, which reduce the pain originating from tender points – often the trapezius and suprascapular muscles if the upper limbs are affected.
- Spinal cord stimulator – “distracts” the body from the pain by interrupting the signals being sent by the sympathetic nervous system to the region involved in CRPS.
- The above interventions are often combined with physical/occupational therapy. The goal of treatment is to allow the patient to participate actively in a rehabilitation regimen and to reduce pain, restore movement, and improve strength of the affected limb.