Topic Overview

What is complex regional pain syndrome?

Complex regional pain syndrome (CRPS) happens when you have severe pain in a part of your body where you may have had an injury. The pain is usually constant and either shooting, sharp, or burning. It lasts much longer than you would expect for the kind of injury you may have had. And it can spread to other areas of your body.

Women in their mid-30s are more likely to get CRPS, but it can happen to anyone at any age.

CRPS is also known as reflex sympathetic dystrophy or causalgia.

What causes CRPS?

Doctors often don't know what causes CRPS. But this condition, and the pain that comes with it, is very real.

The pain usually starts after a limb or joint has had a serious injury, such as a broken bone, a gunshot wound, or a deep wound. The injury might also be caused by an accident, a fall, or surgery. It can even be caused by a minor injury such as a sprain. For some people, CRPS starts without a reason.

What are the symptoms?

Symptoms of CRPS include:

• Pain that's much more severe and lasts much longer than what you would expect for the kind of injury you may have had.
• Skin that may be blotchy or shiny.
• Skin that may feel hotter or colder than other areas of your body.
• Swelling, joint stiffness, weakness, or shaking in the area that hurts.
• Sweating, numbness, or tingling in the area that hurts.

CRPS can also cause anxiety, mood swings, sadness, and depression.

How is CRPS diagnosed?

There's no one test to diagnose CRPS. Your doctor will ask about your symptoms and past health and will give you a physical exam. The exam may include touching your skin or bending your joints in the area that hurts.

Your doctor might also compare the color and temperature of the painful part of your body with the matching, healthy part. For instance, if your left arm hurts, your doctor will compare it to your right arm.

More tests may be needed to rule out other possible causes of your pain and to make a correct diagnosis.

Because CRPS can be so hard to diagnose, you may want to get a second opinion from a doctor who specializes in pain management.

How is it treated?

For some people, the pain from CRPS goes away on its own after a few months. More likely, you'll need a long-term treatment plan.

There are many treatments for CRPS. By using one or more of the treatments listed below, you may be able to reduce your symptoms, help stop the pain from spreading, and feel more relaxed. And you may be able to start using the affected part of your body normally again.

CRPS treatment can include:

• Pain medicines, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin. Other medicines include opiate pain relievers, corticosteroids, anticonvulsants, antidepressants, muscle relaxants, and nerve blocks.
• Surgery, such as intrathecal drug delivery, spinal cord stimulation, radiofrequency ablation, and chemical sympathectomy.
• Physical therapy and occupational therapy, which can include hot-and-cold therapy and range-of-motion exercises. You may have to move your limbs in ways that hurt to do some of these therapies. But moving and using your arms and legs can help you get better.
• Complementary therapies, such as progressive muscle relaxation, biofeedback, acupuncture, guided imagery, massage, aquatic therapy, warm baths, hypnosis, yoga, and meditation.
• Professional counseling, such as cognitive-behavioral therapy.
• Support groups, where you can talk with other people who have CRPS.
• Experimental treatments, such as:
  • Mirror therapy, also known as mirror visual feedback.
  • Drugs that block the immune system, such as low-dose IVIG (intravenous immunoglobulin).

You may have to try more than one kind of treatment before you find what works for you. And you may need to use a few kinds of treatment at the same time. If you want to use more than one treatment, consider going to a pain management clinic where you can get all the treatments you need in one place.