Complex regional pain syndrome (CRPS) is a medical condition characterized by chronic pain. CRPS typically affects one or more limbs, such as the patient’s arm or leg. Patients with CRPS experience severe and often debilitating pain that interferes with normal limb function and daily activities. CRPS has no cure. Typically, the condition continues to worsen instead of heal.
The stages of CRPS are an important factor in the efficacy of treatment. Patients who are diagnosed early and receive treatment during early stages of CRPS are most likely to have a positive outcome from treatment. Stages of CRPS progress from stage one to stage four.
Each of the stages of CRPS is characterized by certain symptom patterns. However, not all CRPS patients will experience each of the symptoms associated with specific stages of CRPS. Additionally, a number of patients do not progress smoothly through each of the stages of CRPS.
Stage One of CRPS
Stage one of CRPS lasts roughly one to three months. Stage one of CRPS typically occurs after the patient has sustained trauma or injury to the affected limb. However, some patients develop CRPS without a known cause. The first stages of CRPS are characterized by intense and burning pain in the affected area.
Patients may experience muscle spasms. During muscle spasms, the muscles in the affected area may contract randomly. This causes sudden, intense pain in most cases. The patient may experience stiffness in the joints of the affected area. Additionally, the patient may notice that the hair, fingernails, or toenails of the affected limb may grow more quickly. The limb may change temperature and color. This is an indication of issues with the blood vessels within the area.
Stage Two of CRPS
Stage two of CRPS is referred to as the dystrophic stage. This stage lasts roughly three to six months. During stage two, symptoms of CRPS will become more pronounced. The pain may continue to intensify. The color and texture of the skin may experience more noticeable changes.
Stiffness and swelling become more severe. As a result, the patient will experience a decrease in muscle tone. Hair in the affected area may grow more slowly. Fingernails or toenails typically become more brittle. This can lead to a cracked, spotty, and grooved appearance. The nails may break or crumble more easily than usual.
Stage Three of CRPS
Stage three of CRPS is referred to as the atrophic stage. Stage three receives its name from the tendency of the muscles, skin, and bones to atrophy, or begin to waste away. The effects of stage three may be irreversible. X-rays may show increased osteoporosis in the bones of the affected limb. Research shows that stage three of CRPS may last for an indeterminate amount of time.
Typically, CRPS pain plateaus and remains constant after roughly three or more years of CRPS. During stage three, CRPS pain may spread to other parts of the body. For example, if the initial injury and CRPS symptoms occurred in the ankle, the pain may spread throughout the entire leg. In some cases, CRPS pain may spread to the arm on the same side of the body, or the other leg.
Stage Four of CRPS
Some specialists do not agree that the stages of CRPS include a fourth stage. Fortunately, most cases of CRPS do not progress to what many refer to as the fourth stage. During the fourth stage, the patient’s condition may be resistant to several forms of treatment.
CRPS may begin to affect the patient’s internal organs. Amputation during this phase may be suggested. However, it is recommended to avoid amputation unless medically necessary for the patient’s survival, such as after the development of gangrene.
Ameer, Khalid, et al. “Diagnosis and Management of Complex Regional Pain Syndrome (CRPS).” Pakistan
Armed Forces Medical Journal 4 (2010). Academic OneFile. Web. 2 Aug.
“Complex Regional Pain Syndrome (CRPS).” AASH. American Society for Surgery of the Hand. Web. 2 Aug
Harden, R. Norman. “Objectification of the Diagnostic Criteria for CRPS.” Pain Medicine 11.8 (2010):
1212-1215. Academic Search Complete. Web. 2 Aug. 2013.
“New Complex Regional Pain Syndromes Study Findings Have Been Reported from Pain Center.” Biotech
Week 8 Feb. 2012: 692. Academic OneFile. Web. 2 Aug. 2013.