Complex regional pain syndrome

Complex regional pain syndrome (CRPS) is a chronic pain condition, causing pain, stiffness, swelling and discolouration of a limb, commonly after an injury to that area. There are two types:
  • Type 1 occurs after an illness or injury - even that may not have directly damaged a nerve in the affected limb.
  • Type 2 follows a distinct nerve injury in that particular limb.
Both of these types are characterised by prolonged or excessive pain of the arm, wrist and hand or leg and foot. While symptoms can vary in severity and duration, for those with severe cases, complex regional pain syndrome can cause long-term disability.

What are the causes of complex regional pain syndrome?

Depending on the type, complex regional pain syndrome is triggered by an injury or illness, or forceful trauma to the affected limb. The cause of CPRS is believed to be a malfunctioning of the peripheral and central nervous systems and an inappropriate inflammatory response.

CRPS most typically starts in one of the arms or legs and beyond chronic pain, swelling and discolouration, symptoms may include:
  • Difficulty moving the arm or leg due to joint stiffness
  • Temperature changes in the skin of the affected area
  • Changes in the texture of the skin in the affected area
  • Changes in nail or hair growth
How is complex regional pain syndrome treated? While there is no simple cure for complex regional pain syndrome, treatment is highly dependent on the severity of the symptoms and how much the disease has progressed. Non-surgical methods may be aimed at improving pain and restoring normality to the patient's life as far as possible. This may involve physical therapy with aerobic conditioning, medications and nerve blocks. Psychotherapy may also be needed to address the emotional effects of chronic pain.

In other cases where a compressed or entrapped nerve may be the cause for pain, surgery may be done to relieve this. Other treatment options include spinal cord stimulation and intrathecal drug pumps. These pumps supply continuous doses of pain medications to the spinal cord to alleviate the pain experienced. Be sure to make an appointment with a specialist at the Garden Route Hand Unit if you are suffering from CRPS to see how best your condition can be managed.