Complex regional pain syndrome, or CRPS, is a disease that causes constant and severe pain accompanied by inflammation. CRPS is a chronic disease that worsens as it progresses. In most cases, the disease is triggered by an injury. There is no known reason that differentiates patients that develop CRPS after an injury from patients that do not. However, studies have shown that patients given vitamin C after an injury have a lower risk of developing CRPS.
Early Indication of CRPS
Patients describe the pain of CRPS as either a burning sensation, or a pins and needles sensation. This pain has shown to score 42 out of 50 of the McGill pain scale, worse than childbirth. Early symptoms of CRPS include pain that is much more severe than expected for the type of injury, pain that spreads from the affected limb or area, and pain that gets worse instead of better after an injury.
Types of CRPS
There are two types of CRPS. Type I is also referred to as Reflex Sympathetic Dystrophy, or RSD. Other names for this disease include: reflex neurovascular dystrophy, Sudeck’s atrophy, and algonuerodystrophy. This is thought to stem primarily from an injury to an arm or leg. In most cases, the injury is minor. The first early symptom of CRPS is this severe pain from a minor injury. The second early symptom of CRPS is often the rapid spreading of pain from the affected area or limb to other parts of the body, with no obvious cause.
Type II is sometimes referred to as causalgia. This is thought to be caused by an injury to the nerves. Type II CRPS shares the same first early symptom as Type I, pain that is not comparable to the injury that it stems from, but that pain is much less likely to spread in the same way that Type I CRPS does. In some cases, an area close to the original site will begin to feel painful, but it is not the same sort of rapid and far-reaching spreading that Type I entails.
Diagnosis of CRPS
There is no specific test that doctors can use to determine the presence of CRPS. The closest doctors have come to finding a test that indicates CRPS is triple phase bone scintigraphy. If tested within a year of the original injury, patients with CRPS show increased radionuclitide accumulations within the joints of the affected area.
CRPS is sometimes misdiagnosed as fibromyalgia, but can be discerned from fibromyalgia by testing for a reaction in the pressure points of the brachial plexus and the intercostobrachial nerve. Doctors also use a number of early symptoms as criteria for diagnosing CRPS.
Early symptoms of CRPS include:
• Swelling• Sensitivity
• Change in temperature
If left untreated, the limb or area may become pale, the muscles may begin to spasm, and the texture and color of nails may change. If CRPS gets to this stage it may be irreversible. This is why it is important to diagnose and start treatment as soon as early symptoms of CRPS are confirmed.
Early Treatment of CRPS
Treatment of CRPS is most effective if it is started within the first few months of symptoms. CRPS is a disease that affects different patients in very different ways, so the treatment must be tailored to the
case. Treatments typically include a combination of medication and physical therapy.
Medications that are sometimes prescribed to treat CRPS include: antidepressants (for the nerve pain relief component of the medication), pain relievers, nerve-blocking medication, and anti-inflammatory. There is often an emotional aspect to dealing with constant pain, so sometimes these drugs are used for dual purposes.
Therapies that are used to relieve and treat early symptoms of CRPS include: physical therapy, application of hot and cold, creams to reduce the hypersensitivity, and application of electrical impulses to nerves or spinal cord. Relaxation techniques are also taught and encouraged.
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“Complex Regional Pain Syndrome Fact Sheet.” National Institute of Neurological Disorders and Stroke.
US Department of Health and Human Services, 12 Jul 2013. Web. 4 Aug 2013.
“Complex Regional Pain Syndrome.” PMC U.S.National Library of Medicine National Institutes of Health.
National Center for Biotechnology Information, U.S. National Library of Medicine, n.d. Web. 4 Aug 2013.