Chronic Regional Pain Syndrome ("CRPS")
Chronic regional pain syndrome (CRPS) is a pain condition that usually affects the arms, legs, hands or feet. Over time the pain can spread into the entire limb involved. CRPS can occur after insult to the site, ie: trauma or surgery, but may occur without any identified injury or trauma. CRPS usually affects an arm or leg.
SYMPTOMS OF CRPS:
Patients typically will notice a change in the color and temperature of the skin overlying the affected limb or body part along with burning pain and sweating. Individuals with CRPS will develop sensitivity, where even blowing on the limb affected or wind can lead to severe pain. The pain is out of proportion to the severity of the initial injury if there is one. Signs of inflammation, including warmth, swelling, and redness are usually present in the initial stages. As CRPS progresses, many patients unfortunately will have a decreased ability to move the affected body part, leading to contractures in some cases. Many individuals will notice changes in skin texture along with changes in hair and nail growth. Symptoms may change with time and do vary in individuals with CRPS. Many times, the changes are irreversible. Emotional stress can worsen the pain.
CAUSES OF CRPS:
There are two types of CRPS with similar symptoms, but different causes. Type I occurs after an illness or injury that does not directly damage the nerves. This is the most common form of CRPS. Type II follows a particular nerve injury. The exact etiology or cause is still unclear, although there are several theories, including the theory that the sympathetic nervous system plays a role and that an immune response can lead to the symptoms.
TREATMENT OPTIONS:
There is no cure as of now, so the mainstay of treatment is geared towards relieving the painful symptoms. Antidepressants and neuropathic medications are often used in treating CRPS. Topical ointments are often times useful to alleviate the pain. Physical therapy is important for range of motion and contraction prevention. Intervention procedures including sympathetic nerve blocks, spinal cord stimulation, and intrathecal drug pumps are often used in treating CRPS.
PROGNOSIS OF CRPS:
The prognosis is variable. Some individuals get better rather quickly, however in some patients the severe and chronic pain can unfortunately lead to irreversible changes despite ongoing treatment. It is important to identify the symptoms in the initial phases, before chronic damage occurs.
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