Complex regional pain syndrome (CRPS) is a medical condition that causes chronic pain in the affected area. The areas most typically affected by complex regional pain syndrome are limbs, such as the patient’s arm or leg. A number of treatments exist to alleviate symptoms. However, the condition is complex and often misunderstood. There is no single cure for complex regional pain syndrome. As a result, patients may never be fully cured.
Types of Complex Regional Pain Syndrome
Complex regional pain syndrome is classified into two types: Type I and Type II. The main difference between Type I and Type II complex regional pain syndrome is considered to involve the cause of the condition. In some cases, the cause of Type I may not be identified. However, Type II can typically be clearly linked to nerve damage.
Type I and Type II CRPS
Many also refer to Type I complex regional pain syndrome as reflex sympathetic dystrophy (RSD). Type I complex regional pain syndrome is considered to be caused by soft tissue injuries within the affected area. These injuries may include sprains, strains, tears, and burns. Nerve damage may or may not be involved. Type II complex regional pain syndrome involves damage to major nerves. Specialists may also refer to Type II as causalgia.
Complex Regional Pain Syndrome Symptoms
As indicated by the condition’s name, the primary symptom of complex regional pain syndrome is chronic pain in a particular region of the body. The progression of complex regional pain syndrome is typically categorized into four stages. However, a patient’s symptoms may not progress sequentially through each of the four stages.
Stage One CRPS Symptoms
Stage one of complex regional pain syndrome typically occurs during the first three months of development of the condition. During stage one, many patients experience intense, burning pain in the area that has been affected. Muscle spasms, swelling, and joint stiffness may also occur. The hair and finger or toenails in the affected area may also grow more rapidly. As a result of blood vessel issues, changes in skin color and temperature may be present.
Stage Two CRPS Symptoms
Stage two is estimated to last roughly three to six months. This stage of complex regional pain syndrome typically involves similar-yet-intensified symptoms experienced during stage one. As a result of prolonged and more advanced swelling and stiffness, the patient may begin to lose muscle tone. Hair, fingernails, and toenails may begin to slow in growth.
Stage Three CRPS Symptoms
Stage three of complex regional pain syndrome is characterized by atrophy, or wasting away of the affected skin, muscles, and bones. Due to the advanced nature of this stage, symptoms may not be reversible. Patients in stage three may notice that pain and other symptoms may begin to plateau or vary from day to day. Additionally, the pain may spread. Initial pain in a patient’s wrist may spread to the remainder of the arm.
Stage Four CRPS Symptoms
Debate exists over the existence of stage four complex regional pain syndrome. For those who acknowledge stage four, it is characterized by resistance to many forms of treatment. In the most advanced stages, the internal organs of the patient may become affected. Prognosis is poorest for those in stage four.
Complex Regional Pain Syndrome Treatment
Treatment for chronic regional pain syndrome is often most effective for patients who receive treatment during earlier stages. If a patient’s chronic regional pain syndrome progresses into advanced stages, more aggressive treatment may be needed. In some cases, the prognosis is poor. Many chronic regional pain syndrome patients do not reach full recovery. For these patients, lifetime maintenance techniques must be used to alleviate symptoms.
Treatment for complex regional pain syndrome may include:
- Physical Therapy. Physical therapy may help to encourage mobility, pain reduction, and increased muscle strength in the affected area. Physical therapy may involve topical treatment such as heat, cold, and analgesics to alleviate hypersensitivity.
- Surgical Treatment. Sympathectomy is a type of surgical treatment for complex regional pain syndrome. This treatment involves cutting and cauterizing the sympathetic nerve, which runs along the spinal column. The sympathetic nerve plays a role in transmitting pain within the body.
- Alternative Treatment. Patients in advanced stages may seek alternative treatment. Acupuncture may be used to alleviate pressure points. Nutritional supplements, herbal remedies, and a special diet may be used to reduce bodily inflammation and improve the patient’s immune system.
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