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Complex Regional Pain

Complex regional pain syndrome (CRPS) is a greater than normal
reaction of the body to an injury. The symptoms of CRPS vary in severity
and how long they last. The main symptom is pain in an arm or leg,
which is often burning, sharp, stabbing or stinging. Early treatment is
often effective in treating symptoms. CRPS can sometimes cause severe
problems and be difficult to treat.

What is complex regional pain syndrome?
Complex regional pain syndrome (CRPS) is a greater than normal reaction of the body to an injury.
The cause of CRPS is not known. The nerves in the affected limb are much more sensitive than
other nerves and this causes pain and tenderness in the affected area.
The pain usually starts after an injury but may occur without an injury. It usually affects an arm or a
leg but can affect another part of the body. The injury may be severe, such as a broken bone or a
damaged nerve, or may be a minor injury.
CRPS is not in your imagination but some emotional factors, like fear, worry or feeling depressed,
can make the pain worse.

Related discussions


Complex Regional Pain SyndromeGuest9 replies

The main symptom is pain in the . What are the symptoms of complex regional pain syndrome? The symptoms of CRPS vary in severity and how long they last. It can also affect children and the number of CRPS cases among teenagers and young adults is increasing. CRPS can affect any age but is more common between the ages of 40 and 60 years.could this be CRPS?madcow19644 replies  CRPSGuest4 replies  Start a discussion » What causes complex regional pain syndrome? There is often a history of an injury. CRPS can also start after other problems such as a head injury.000 people each year. heart attack or prolonged bed rest. How common is complex regional pain syndrome? CRPS affects about 1 in 4. stroke. it is more common after an injury to a nerve or after a fracture. The symptoms do not appear to be related to the severity of the injury. Symptoms usually begin within one month after an injury or after having to stay in bed for a long time. if it occurred at all. The injury may not be remembered. Although CRPS can start after a minor injury.Burning pain and stinging nettle senations . The injury may be very minor such as a cut to the finger.

CRPS pain continues after the original injury has healed. dry or scaly.  Fingernail or toenail changes: nails in the affected area may become brittle (crumbly or break easily) and grow faster at the beginning and then slower. . both because of the pain and because joints can be stiff. tremors.  Your skin may become shiny. Other muscle problems may occur and include sudden and severe spasms. The pain is long-lasting. There may also be tingling and numbness. The symptoms may spread gradually over the affected limb or suddenly affect the opposite limb. This may be felt as severe pain. The pain and other symptoms often spread beyond the site of the original injury. and gets worse rather than better with time. Many patients say that their limb 'feels strange'. severe jerking and other abnormal movements. Movement may be limited. The pain may spread to other limbs. Sometimes the limb feels bigger or smaller than normal. sharp. It can feel as if it does not belong to the rest of the body and as if it is not your own limb. like 'goosebumps' and skin rashes. The symptoms are often severe and have a big effect on day-today activities.  Skin changes:  Abnormal skin changes may occur. stabbing or stinging.  Swelling: may occur over the painful region. such as clothes brushing your skin or even air blowing on your skin. The symptoms are usually much worse than you would expect after the injury. Staying in bed and not moving around may make the pain and stiffness worse. which is often burning.arm or leg. the affected area may have other symptoms such as:  Skin sensitivity: the skin may become oversensitive to light touch. The muscles may become weak.  There may be changes in the skin colour of the affected limb.  Abnormal sweating.  Hair changes: hair may become coarse but then become thin.  Skin infections can occur and can be very severe.  Allodynia: this means that you feel pain even after just a gentle touch.  Temperature differences between opposite sides: the affected arm or leg may often be warmer or cooler and the temperature may keep changing. As well as pain.

There are no specific blood tests or other investigations. Other treatments may reduce pain. The right treatment for CRPS is different for each person. especially in the early stages. Do I need to see a specialist? Your GP will usually refer you to see a specialist so that:  The diagnosis of CRPS can be confirmed. or be support and treatment for any psychological difficulties. .  You can be helped with with a treatment plan to control the difficult symptoms.Psychological symptoms Psychological symptoms may include:  Difficulty relaxing  Feeling less confident in yourself  Feeling unable to cope  Difficulty getting or accepting support from friends or family  Depression (this is common) Are there any tests for complex regional pain syndrome? The diagnosis is usually made by an examination by a specialist. The diagnosis may be difficult. including pain and distress. Treatment includes helping you to understand the condition and what you can do to help yourself. Are there any treatments for complex regional pain syndrome? Early treatment is often very effective in treating symptoms.  Treatment to keep you as active as possible can be provided. However.  Other causes for your symptoms can be ruled out. including physiotherapy. investigations may be important to rule out any other cause for your symptoms. It is very important to diagnose CRPS as early as possible because early treatment can prevent the arm or leg becoming weak because you can't use it properly. or be physical treatments like physiotherapy.

Simple medicines for pain relief such as non-steroidal anti-inflammatory drugs (NSAIDs) are used first and the strength and doses of the medicines are increased until the pain is well controlled. It may be given as a one-off treatment if you have had CRPS for less than six months. Rehabilitation includes helping you to use the limb with gentle exercises and helping to make the limb less sensitive. Support and treatment from a physiotherapist and an occupational therapist are very important. Because of the different symptoms with CRPS. See the separate leaflet called Neuropathic Pain. . you may need to see other teams of doctors. such as:  a bone specialist (orthopaedic specialist)  a bone and joint specialist (rheumatologist)  a nerve specialist (neurologist) and  a skin specialist (dermatologist) Rehabilitation Rehabilitation should be considered for anyone with CRPS and should be started early.If your symptoms are more severe and don't improve with treatment then you may need to be referred to a Pain Clinic or another specialised unit for further treatments. Related Wellbeing _  Helen's story: Complex Regional Pain Syndrome  See all Wellbeing » Medication treatment Medicines can be used to help reduce the pain and help you to sleep. If the pain is not reduced then other types of medicine are used . Medications may also be needed for depression. Other treatments help you to use the limb more normally and reduce any fluid swelling (oedema). Specialised units may also use more specialised treatments such as mirror visual feedback and graded motor imagery. tricyclic antidepressants orgabapentin. Pamidronate is a bisphosphonate medicine that is given by slow injection into a vein.for example.

What are specialised treatments for CRPS? There are two particular specialised CRPS treatments: Pain management programme (PMP): this is a programme to help you to improve your quality of life and manage your pain better. including doctors. CRPS can spread and affect other limbs. The periods of exacerbation may last for weeks. What is the outcome (prognosis)? CRPS is very variable both in how severe the symptoms are and how long the symptoms last for. if it works well. PMP is given to a group of people with CRPS and includes help from different health professionals. The wire is kept in place for a short time and. the rest of your body will continue to work as normal. The SCS can be taken out when it is not needed anymore.Psychological support and treatment Sometimes psychological treatment can help to reduce distress. and when. an operation can be done to make it permanent. Specialised centres may also use other treatments. occupational therapists and psychologists. This makes CRPS much harder to treat. CRPS can cause severe symptoms and last for many years. Some people with CRPS have times when the symptoms are bad (exacerbations) and other periods of time when the symptoms are much fewer or even disappear (remissions). Psychological interventions (including cognitive behavioural therapy and relaxation techniques) can help the psychological difficulties associated with CRPS. Research shows that in some patients these treatments can work very well. In some people. CRPS may be mild and get better by itself or with treatment. months or years. The evidence for these specialised treatments is not completely proven but many people with CRPS have found one or more of them very helpful. A psychological assessment by an expert in chronic pain may help to identify problems that can be helped. Spinal cord stimulation (SCS): this involves using a fine wire which is placed close to the nerves in your back and is connected to a 'stimulator'. If it is not diagnosed and treated. physiotherapists. . Even if you have CRPS for several years. There is no way of knowing whether your symptoms will get better.

.Can complex regional pain syndrome be prevented? People experiencing fractures have been advised to have a good intake of vitamin C but there is no proven way that CRPS can be prevented.