Complex Regional Pain Syndrome (CRPS)

What is Complex Regional Pain Syndrome?

Individuals who have complex regional pain syndrome or CRPS, experience chronic pain, which usually occurs in a leg, foot, hand or arm. This condition is thought to be caused when the central nervous system and peripheral nervous system sustains damage or fails to function properly.

This disorder often occurs following an injury to the painful limb. When the nerves in a limb become damaged this can lead to additional health problems that have a negative impact on the muscles, skin, blood vessels and bones. The level of pain each person experiences will differ and while some people eventually recuperate, others will never improve.

What are the Symptoms of Complex Regional Pain Syndrome?

A common symptom of complex regional pain syndrome is an intense burning pain in the affected limb. The whole limb may also be painful and it is not uncommon for the pain to spread to the opposing limb. The limb often becomes swollen and tremors can cause the limb to make unexpected motions. Symptoms of CRPS will also affect the skin and it may have a shiny appearance and feel hot or cold. The joints in the limb can become stiff and this makes it difficult for individuals to freely move the limb. A person’s hair and nails can also be impacted and grow at a quick pace or not at all.

Complex Regional Pain Syndrome Causes

While the specific causes of complex regional pain syndrome (CRPS) in some individuals are unknown, when others who experience similar injury do not develop it, the main cause of this phenomena is trauma to nervous tissue. Though the trigger of CRPS is trauma, the two types of CRPS manifest differently. Type 1 is caused by injury or other damage to nerves that are not in the affected area, and this is most common in the arms and legs.

Type 2 is caused by direct injury to the nerves of the affected area. About 90% of cases, regardless of type, can be caused by various types of trauma including bone fracture; sprains and/or strains; burns; abrasions; contusions; immobilization of a joint, as in casting an injured bone or with joint injury; surgery; and has been noted with minor medical procedures such as needle sticks. Individuals may also be more susceptible to developing CRPS due to genetic factors; however, data on genetic components is limited. Additionally, in 10% of cases, CRPS is idiopathic and no cause is found. In rare instances, myocardial infarction and cerebrovascular accident, or stroke can trigger CRPS.

How is Complex Regional Pain Syndrome Treated?

Medical professionals offer various methods of treatment for CRPS.

Treatment includes

Rehabilitation therapy is often recommended to keep the blood circulating properly and to strengthen the limb. Medications are often prescribed to help relieve symptoms and treat the disease. Common medications include corticosteroids, anti-inflammatory medications, seizure medicine, topical creams and botulinum toxin injections. Additional treatments, such as sympathetic nerve block, spinal cord stimulation and surgical sympathectomy, are also options for people who have complex regional pain syndrome.

Complex Regional Pain Syndrome Prevention

While it is noted that in some cases, prevention is not possible, early intervention is the best chance to prevent the development of complex regional pain syndrome. Supplementation with vitamin C immediately after trauma or surgery has been noted to prevent CRPS. While the specific mechanism for this is currently unknown, this has been shown to be effective. Additionally, mobilization soon after surgery, injury, heart attach, or stroke is effective in preventing CRPS. Additionally, though myocardial infarction and stroke are rare causes of CRPS, taking steps to prevent these events will, in turn, prevent the development of CRPS. If these steps are taken in combination, it is likely to provide additional preventative measures against developing CRPS.

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Last Reviewed:
September 19, 2016
Last Updated:
December 08, 2017