Complex regional pain syndrome

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Overview

Symptoms

Treatment

Prevention

Complex regional pain syndrome

Definition:

Complex regional pain syndrome (CRPS) is a chronic pain syndrome with two forms. CRPS 1 currently replaces the term "reflex sympathetic dystrophy syndrome". It is a chronic nerve disorder that occurs most often in the arms or legs after a minor or major injury.

CRPS 1 is associated with severe pain; changes in the nails, bone, and skin; and an increased sensitivity to touch in the affected limb. CRPS 2 replaces the term causalgia, and results from an identified injury to the nerve.

Symptoms:

In most cases CRPS has 3 stages. Often, however, CRPS does not follow this progression. Some people go into the later stages almost immediately. Others remain in Stage 1 indefinitely.

Stage 1 (lasts 1-3 months)

Severe burning, aching pain increasing with the slightest touch or breeze
Swelling with warmth or coolness
Skin becomes dry and thin, changes color
Increased nail and hair growth
Pain may move further up or down the affected limb

Stage 2 (lasts 3-6 months)

Swelling spreads
Noticeable changes in skin texture and color
Decreased hair growth
Changes in bone seen in x-rays
Stiff muscles and joints

Stage 3 (irreversible changes become evident)

Pain may exist in the entire limb
Permanent tissue changes
Muscle wasting
Limited mobility in limb
Contractions involving muscles and tendons

Depression or changes in mood may accompany these symptoms, especially in stage 3.

Signs and tests:

Diagnosing CRPS can be difficult, but early diagnosis is very important. Often, the symptoms are severe compared to the original trauma or injury.

It is possible to make a diagnosis based on a medical history and physical examination. The key complaint is the severe, burning pain. Additional tests may include x-rays, bone scans, nerve conduction studies, and thermography (a test to show temperature changes and lack of blood supply in the painful area of the affected limb).

Review Date: 5/16/2006
Reviewed By: Daniel Kantor, M.D., Director of the Comprehensive MS Center, Neuroscience Institute, University of Florida Health Science Center, Jacksonville, FL. Review provided by VeriMed Healthcare Network.

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