CRPS Complex Regional Pain Syndrome

When it comes to mid-life, there are changes. There are pains of all kinds. New and old. Some are lifestyle related and some seem to emerge from nowhere. They aren’t fibromyalgia, neuralgia, rheumatism. They fall into the cracks between the planks of established. The pains are more than one. They are syndromes that develop with age. One such syndrome is Complex Regional Pain Syndrome or CRPS for friendliness.

Having a Complex Regional Pain Syndrome is one of hundreds of physical, mental and emotional syndromes that confuse patients and doctors.

Complex regional pain syndrome (CRPS) is a chronic (lasting greater than six months) pain condition that most often affects one limb (arm, leg, hand, or foot) usually after an injury. CRPS is believed to be caused by damage to, or malfunction of, the peripheral and central nervous systems. According to Stanford Medical schools, the main symptoms are severe pain, swelling, and changes in the skin. Although CRPS can occur anywhere in the body, it usually affects an arm, leg, hand, or foot. CRPS can make your life seem very crappy.

In this era of specialization, it is very difficult to localize pain issues and CRPS may become worse or better over time periods of less than one year. When it flares, it is disabling. Yet, insurance approaches have severely limited restrictions on seeing a disease as a singular entity or as a syndrome of several.

One method of diagnosis, apart from the observation of symptoms, is a bone scan. MRI scans and X-rays are also used to detect CRPS, for much the same reasons as bone scans. X-rays may be able to pick up irregularities or mineral loss from bones, while MRI’s can show a number of tissue irregularities.

According to the Mayo Clinic, CRPS is thought to be caused by an injury to or an abnormality of the peripheral and central nervous systems. CRPS typically occurs as a result of a trauma or an injury. Complex regional pain syndrome occurs in two types, with similar signs and symptoms, but different causes. Are these causes due to passed indiscretions (falls, accidents, traumas) that you recovered easily from earlier years? CRPS appears ti the 40’s as changing-life issues develop in women and men. According to the Mayo Clinic, CRPS is divided into two types: CRPS-I and CRPS-II. Individuals without a confirmed nerve injury are classified as having CRPS-I (previously known as reflex sympathetic dystrophy syndrome). CRPS-II (previously known as causalgia) is when there is an associated, confirmed nerve injury.

CRPS I, formerly known as reflex sympathetic dystrophy (RSD)—here, no nerve lesions can be identified. A dystrophy is a muscular disease and RSD is treated as among the hundreds of dystrophies exhibiting muscle weaknesses. Alas, there are no specified treatments or cures for muscular dystrophies.

CRPS II (formerly known as causalgia). The symptoms of this syndrome include evidence of a nerve lesion.

CRPS/RSD is a life-altering chronic condition. Living with CRPS/RSD offers many challenges to those who are affected by it. Challenges include difficulties with diagnosis, coping strategies after diagnosis, caregiver concerns, differences in the problems faced by adults and youths, insurance, workman’s compensation and other issues.

While there are some research studies, data and conclusions are still sparse.

Perhaps one of the most simple of the problems is that most pain management professionals still don’t know how to diagnose CRPS as a syndrome. They only treat symptoms.

There is no single diagnostic tool for CRPS or RSD. Physicians diagnose it based on patient history, clinical examination, and laboratory results. Physicians must rule out any other condition that would otherwise account for the degree of pain and dysfunction before considering CRPS/RSD.

Early diagnosis and appropriate treatment offer the highest probability of effective treatment and possible remission of CRPS/RSD

CRPS symptoms include:
Pain that is described as deep, aching, cold, burning, and/or increased skin sensitivity
An initiating injury or traumatic event, such as a sprain, fracture, minor surgery, etc., that should not cause as severe pain as being experienced or where the pain does not subside with healing
Pain (moderate-to-severe) associated with allodynia, that is, pain from something that should not cause pain, such as the touch of clothing or a shower
Continuing pain (moderate-to-severe) associated with hyperalgesia, that is, heightened sensitivity to painful stimulation)
Abnormal swelling in the affected area
Abnormal hair or nail growth
Abnormal skin color changes
Abnormal skin temperature, that is, one side of the body is warmer or colder than the other by more than 1°C
Abnormal sweating of the affected area
Limited range of motion, weakness, or other motor disorders such as paralysis or dystonia
Symptoms and signs can wax and wane
Can affect anyone, but is more common in women, with a recent increase in the number of children and adolescents who are diagnosed

The Mayo Clinic offers some extensive clinical information on CRPS and/or RSD.

It represents many CRPS chronic pain issues. So there may be more than 1 source of chronic pain. There may be syndromes. CRPS is one of them.