The following information may help to address your question:
What is complex regional pain syndrome?
Complex regional pain syndrome
(CRPS) is a chronic pain condition that mainly affects the arms, legs, hands, and feet, but may involve the entire body. CRPS symptoms often begin after surgery or an injury.
The main feature of CRPS is continuous, intense pain that is out of proportion to the severity of the injury. The pain gets worse over time and often spreads throughout the entire affected area.
Other symptoms may include color and temperature changes of the skin over the affected area; skin sensitivity; sweating; and swelling.
The underlying cause of CRPS is often not known. Two classifications of CRPS have been recognized based on causalgia. Type I
(also known as reflex sympathetic dystrophy), in which there is no evidence of peripheral nerve injury and Type II, in which peripheral nerve injury is present. Treatment aims to relieve pain and often includes different interventions such as topical or oral medications; physical therapy
; and/or a sympathetic nerve block
Last updated: 1/9/2017
What are the signs and symptoms of complex regional pain syndrome?
Complex regional pain syndrome (CRPS) usually develops after an injury, surgery, stroke or heart attack.
The key symptom of CRPS is continuous, intense pain that is out of proportion to the severity of the injury. The pain gets worse over time. CRPS most often affects one of the arms, legs, hands, or feet, and the pain often spreads throughout the entire affected arm or leg.
Other signs and symptoms may include:
- sensitivity to touch or cold
- swelling of the painful area
- changes in skin temperature, color, and/or texture
- joint stiffness and swelling
- muscle weakness and/or muscle spasms
Symptoms may change over time and vary from person to person. In some people, signs and symptoms of go away on their own. In others, symptoms can persist for months to years.
Last updated: 11/11/2014
What causes complex regional pain syndrome?
The underlying cause of complex regional pain syndrome (CRPS) is not well understood. In most cases it occurs after an illness or injury that did not directly damage the nerves in the affected area (Type I). In some cases, it occurs after a specific nerve injury (Type II). The exact trigger of CRPS after an injury is not known, but it may be due to abnormal interactions between the central and peripheral nervous systems, and/or inappropriate inflammatory responses.
Last updated: 3/31/2016
How might complex regional pain syndrome be treated?
There is no known cure for complex regional pain syndrome (CRPS). Treatment includes a multidisciplinary approach with the aim of controlling pain symptoms. It has been suggested that when treatment is started within a few months of when symptoms begin, improvement or remission
may be possible.
A combination of therapies is usually necessary including medications, physical and occupational therapy, interventional procedures, and psychosocial/behavioral management.
Medications may include:
- Oral and topical pain relievers
- Antidepressants or anticonvulsants (which are sometimes used to treat pain)
- Bone-loss medications
- Sympathetic nerve-blocking medications
- Intravenous anesthetics (Ketamine)
- Intravenous immunoglobulin
Interventional procedures may include:
Other therapies may include applying heat or cold; electrical nerve stimulation; and biofeedback.
Psychosocial and behavioral aspects of CRPS should be addressed, and it has been suggested that people with chronic CRPS should have a thorough psychological evaluation. This may be followed by cognitive-behavioral pain management, including relaxation training with biofeedback.
Unfortunately, published research studies validating the efficacy of these treatment options are limited and no single drug or therapy (or combination) has shown consistent, long-lasting improvement.
For more information on treatment options for CRPS, view information from the Reflex Sympathetic Dystrophy Association of America (RSDSA).
Last updated: 3/25/2016
What is the long-term outlook for people with complex regional pain syndrome?
The long-term outlook (prognosis
) for people with complex regional pain syndrome (CRPS) varies from person to person.
In some people, signs and symptoms go away on their own; this is called spontaneous remission. In others, symptoms may persist for months or years and there may be irreversible problems.
Treatment is likely to be most effective when it is started early in the course of the illness, so early diagnosis and treatment may improve the prognosis.
The vast majority of children with CRPS have a good prognosis.
Last updated: 11/11/2014
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