Complex Regional Pain Syndrome (CRPS)

This handout was written to teach you about complex regional pain syndrome (CRPS) and its treatment.

 

CRPS, which used to be called Reflex Sympathetic Dystrophy (RSD), is a chronic pain syndrome that involves a region of the body, often one arm or leg.  CRPS is rare, but can be very disabling.  CRPS may start after trauma, surgery, or prolonged use of a cast or splint.  The injury is often very mild compared to the pain of CRPS.   

 

The symptoms of CRPS vary in people, but most people have constant, severe, burning pain in one part of the body, plus sensitivity to heat, cold, and light touch.  Even the slightest touch or brush of clothing can be painful.  There may also be swelling, increased or decreased sweating, thinning of the skin, and increased hair and nail growth.  The arm or leg might become very cool and purple, but in some patients it is warm and red.  X-rays may show early osteoporosis (thinning of the bones).

 

CRPS is so painful that many people have trouble moving their arm or leg.  This can lead to muscle stiffness, weakness, and atrophy (wasting).   The less the person moves the limb, the worse the symptoms can become.  For example, patients with CRPS of the hand can develop a painful elbow or shoulder after holding the arm stiffly for a long time.  (This does not mean the CRPS is “spreading” up the limb.)  Casting or splinting can make CRPS worse.

 

CRPS is so painful that many people have trouble moving their arm or leg.  This can lead to muscle stiffness, weakness, and atrophy (wasting).   The less the person moves the limb, the worse the symptoms can become.  For instance, patients with CRPS of the hand can develop a painful elbow or shoulder after holding the arm stiffly for a long time.  This does not mean the CRPS is “spreading” up the limb.  Casting or splinting can make CRPS worse.

 

The cause of CRPS is still unclear, but it may be caused by changes in the nerves after injury.  Nerves that send pain signals become more sensitive, and non-pain nerves begin sending pain signals as well.  Doctors are looking for ways to prevent these changes or stop them from getting worse.  At this time, there is no certain cure for CRPS.

 

Once your doctor decides that you have CRPS, you will need a treatment plan.  The goal is to reduce pain, regain normal movement, and restore use of your arm or leg.  Treatment may include medicines, nerve blocks, physical and/or occupational therapy, and psychosocial support.

 

Treatment often begins with gentle stimulation to the painful area using heat, massage, pressure, cold, and movement to help restore normal feeling. This is followed by a gradual increase in motion exercises, followed by exercises to strengthen.  Restoring movement is a key part of treatment.

 

Nerve blocks are injections that can provide relief of pain for a short time.  They may be used to reduce pain enough to help a person do their exercises.  Different people may need different kinds and numbers of blocks. 

 

Many pain medicines can help reduce the pain of CRPS.  Your doctor will suggest different combinations of medicines, with the goal of finding what works best for you.  Drugs that work well for one person may not be right for someone else, and it may take some time to find what will work for you.

 

Because living with chronic pain can be hard both physically and mentally, psychosocial support is very important.  Counseling, support groups, relaxation training, and other activities can help you cope better with pain even as you undergo treatment.

 

Your treatment team may include your doctor, nurse, physical and occupational therapist, psychologist, and many others.  They will all play an active role, but you are the most important person on the treatment team.  With your active participation, you and your team can work to reduce your pain, restore your movement, and improve your life.

You can find out more about CRPS from:

 

Reflex Sympathetic Dystrophy Syndrome Association of America (RSDSA)

P.O. Box 502

Milford, CT 06460

(203) 877-3790

http://www.rsds.org/index2.html

 

Other Web sites:

http://www.womenshealthchannel.com/rsd/index.shtml#symptoms

 

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 10/28/2009

Copyright © 10/28/2009 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. UWH #5762

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