Understanding Complex Regional Pain Syndrome

The National Institute of Neurological Disorders and Stroke defines complex regional pain syndrome (CRPS) as a rare autoimmune condition characterized by “excess and prolonged pain and inflammation following an injury to an individual’s arm, foot, hand, or leg.” Most people develop this condition after surgery or tissue-related injury.


According to the Spero Clinic, one the leading CRPS treatment centers in the country, what differentiates CRPS from other conditions that develop after an injury, fracture, or sprain is the resulting pain, which is usually persistent, severe, intense, and long-lasting. It’s important to note that the pain and complications arising from CRPS can sometimes spread and impact the entire body.


People with this condition tend to experience spontaneous pain or debilitating pain that’s much more than what is expected when recovering from surgery or an injury. In fact, it is described as an “uncommon form of chronic pain.” That’s not to mean that those with CRPS don’t get better— most people make a full recovery. However, symptoms can persist for months or even years for some people. There are also cases where CRPS recurs after recovery. Here’s what else you need to know:


How Common is Complex Regional Pain Syndrome?

Your doctor may have mentioned that your symptoms following a fracture, injury, or surgery could possibly be a chronic neuro-inflammatory disorder— and CRPS in particular. You may have even wondered how common this condition is.


The United States Food and Drug Administration classifies CRPS as a rare and unusual type of neuro-inflammatory disorder that affects up to 200,000 people in the US every year. The autoimmune condition has also been shown to have an estimated incidence of about 26.2 per 100,000 person-years. Plus, it’s more prevalent in females (at least 3 times more) than in males.

CRPS has been divided into two categories depending on the causation or rather inciting event. They are:


  • CRPS Type 1. It’s the most common type with approximately 90 percent of all diagnosed CRPS cases. Involves cases that can’t be definitively linked or associated with specific nerve injury. Causation may include an initiating injurious event, such as a sprain, fracture, or tissue-related injury. May also develop following immobilization with a brace, cast, or splint.
  • CRPS Type 2. Occurs with documented and defined nerve injury.


However, there has been debate about these two categories since nerve damage has been reported in patients with CRPS-1 as well.


What are the Symptoms of CRPS?

As with most autoimmune conditions, the severity of symptoms associated with CRPS and how long they last vary widely. While some patients may fully recover within one to six months, others may experience recurring episodes over a long period of time. The resulting pain can become worse over time, spreading to other body areas or even the entire body. In addition to the debilitating pain, patients may experience the following symptoms:


  • Skin swelling in the affected area as a result of fluid build-up
  • Increased stiffness and loss of function in the affected limb
  • Abnormal or no sweating
  • Inconsistent changes in skin color and temperature
  • Changes in skin texture (looks thin and shiny)
  • Decreased or increased nail and hair growth
  • Limited range of motion and impaired muscle strength in the limb
  • Weakness and decreased ability to move the affected limbs
  • Painful and inflamed joints


Many patients with this chronic neuro-inflammatory disorder are sometimes seen as being psychologically different due to some of the symptoms they exhibit and complain about. This often results in stigmatization as people around the patient can’t understand the ‘mysterious’ pain. After all, they look normal. This stigma is exacerbated if it takes months for physicians to get a diagnosis of CRPS, as is the case with Tricia Skiba.


What are the Common Causes of CRPS?

First, CRPS is an autoimmune disorder that’s widely misunderstood and less known by physicians and other medical practitioners. This explains the increasing cases of misdiagnosis and wrong treatments given to patients.


While some scientists argue that CRPS develops due to general inflammation and dysfunction in a person’s sympathetic, peripheral, and/or central nervous systems, the exact cause hasn’t been clearly identified and understood. Some of the factors that are believed to contribute to the development of CRPS include limb immobilization (such bracing, splinting, and casting), surgery, fractures, sprains, strains, and other soft-tissue injuries.


CPRS Diagnosis and Testing

You may have been to a doctor’s office and they couldn’t run any diagnostic tests for your condition. Instead, they requested your medical history and asked questions to understand the symptoms you were experiencing. No lab tests. Only a thorough physical examination. That’s exactly how CPRS is diagnosed.


However, you must note that, in some cases, your physician may need to carry out MRI scans, X-Rays, bone scans, skin sensitivity tests, and blood tests. This is to help them rule out the possibility of other conditions with similar symptoms. It’s not uncommon for patients to receive a mistaken or delayed diagnosis of CRPS. As mentioned, the condition is not widely known which means you need to see a physician who is aware of and understands the signs of symptoms associated with CRPS.


CRPS Treatment

As with other medical conditions, early diagnosis and treatment are crucial to prevent serious complications. There are many conditions that have no cure, and CRPS is one of them. That doesn’t mean patients are doomed to live with the condition forever. No. Treatment often involves relieving the different symptoms and complications associated with CRPS. Treatment options include:


  • Medication and Drug Treatments such as Botox injections, antidepressants, Topical creams and patches, opioids, bisphosphonates, N-methyl-D-aspartate receptor antagonists, narcotics, corticosteroids, etc.
  • Physical therapy
  • Psychological support
  • Spinal cord stimulation
  • Intrathecal drug pumps
  • Surgical sympathectomy
  • Sympathetic nerve blocks
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