Complex regional pain syndrome (CRPS) is a medical condition that causes chronic pain in those afflicted.CRPS can affect any region of the body. However, CRPS typically occurs in limbs such as an arm or a leg. While there is no specific cure for the condition, early treatment may result in remission or reversal. Many medical professionals classify CRPS into four main stages based on progressive symptoms of the condition.
Stage three is referred to as the “atrophic stage.” Patients suffering CRPS for more than a year are considered to be in stage three of CRPS. Stage three of CRPS has a less hopeful outcome, as treatment is generally less effective for patients in this advanced stage. Damage to the bones, tissue, and skin may be irreversible in this stage of the condition.
Stage three of CRPS gains its name from characteristic atrophy of the muscles, bones, and skin in the affected region. The affected limb may also be displaced from the normal position. Atrophy is defined as the partial or complete wasting of an organ, tissue, or other body part. Stage three CRPS atrophy is primarily caused by lack of use of the affected area. Many patients find CRPS pain debilitating. As a result, most patients refrain from using the affected area unless necessary.
In addition to intense pain, tightness in the affected region contributes to limb atrophy. Many patients experience contracture, or permanent shortening of the affected muscles and tendons. This results in involuntary limitations on the limb’s mobility. Additionally, X-rays may reveal notable demineralization of bone and increased signs of osteoporosis. Osteoporosis is characterized by weaker and more fragile bones.
Stage Three CRPS Pain
During stage three of CRPS, the intensity of pain will typically reach a plateau. CRPS pain is generally constant. However, most patients experience increases and decreases in pain as time passes. Some days may be characterized by extreme pain, while other days are more manageable.
The pain may spread from the initially-affected area. For example, if CRPS first developed in a patient’s wrist, stage three of CRPS may result in pain throughout the entire arm. The pain may also spread to other parts of the body. CRPS pain from the right arm may spread to the left arm, or throughout the right side of the patient’s body.
SMP vs. SIP Pain
In the first two stages of CRPS, the patient’s pain is primarily referred to as sympathetically-medicated pain (SMP). SMP is also referred to as sympathetically-maintained pain. Many patients with SMP may find relief with treatment such as nerve-block therapy. Nerve-block therapy involves blocking a sympathetic nerve by injecting an anesthetic into the nerve or area where several nerves meet.
During stage three of CRPS, a patient’s pain often develops into sympathetically-independent pain (SIP). SIP usually originates from the patient’s brain, as opposed to the original location of the CRPS development. Unfortunately for many patients, treatment for nerve-block therapy is generally ineffective for treating SIP.
Other Stage Three Symptoms
During stage three of CRPS, the patient’s skin may appear thin and shiny. During the earlier stages of CRPS, the skin of the affected area often fluctuates temperature from warm to cold. However, during stage three of CRPS, the affected skin typically maintains a cool temperature.
Stage Three CRPS Prognosis
Prognosis for stage three of CRPS is generally poorer than the prognosis for earlier stages of the condition. This is primarily due to the irreversible damage that can occur to the affected muscles, bones, tissues, and skin. Patients who receive aggressive treatment in the earlier stages of CRPS are significantly more likely to experience improvement in the condition. Early treatment may also prevent the patient’s CRPS from progressing to more advanced stages.
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