Complex regional pain syndrome (CRPS) refers to a chronic condition affecting the nerves and blood vessels of one or more extremities. It is distinguished by extremely unpleasant burning sensations, swelling, sweating, color changes, and other distressing symptoms.
There are two types of CRPS:
The cause of CRPS is not known. The condition likely results from several factors. It may involve overactivity of the sympathetic nervous system, which directs automatic body functions that a person cannot control. Inflammation also may play a role in the disorder.
Minor or severe trauma increases the risk of CRPS:
If you have any of these symptoms do not assume it is due to CRPS. These symptoms may be caused by other conditions.
The upper extremities, particularly the hands, are most commonly affected. Symptoms progress and may vary during the course of the condition. Pain may spread from one side of the body to another. Many doctors describe symptoms in terms of stages.
Tell your doctor if you have any of these:
Symptoms may include:
Symptoms may increase with stress and worsen over time.
Symptoms may include :
Symptoms may include :
Your doctor will ask about your symptoms and medical history and perform a physical exam. To diagnose CRPS, the doctor uses four criteria:
Tests may be ordered to rule out other conditions. Your doctor may refer you to a pain specialist for further evaluation and management. Tests may include the following:
Treatment aims to relieve pain and improve function. Visit the doctor as soon as possible. Early therapy may lead to better outcomes. In some cases, the condition goes away on its own; this is more common in children.
Treatment options include:
RESOURCES:
International Research Foundation for RSD/CRPS
http://www.rsdfoundation.org/
Reflex Sympathetic Dystrophy Syndrome Association
http://www.rsds.org/
CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca/index_e.html/
Promoting Awareness of RSD and CRPS in Canada
http://www.rsdcanada.org/parc/
References:
Cecil RL, Goldman L, Bennett J. Cecil Textbook of Medicine. 21st ed. Philadelphia, PA: WB Saunders Company; 2000.
Chelimsky T, Armitano E, Pidgeon J. Complex Regional Pain Syndrome. In: Gilman S, ed. MedLink Neurology website. Available at: http://www.medlink.com . Accessed February 4, 2009.
Complex regional pain syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated December 17, 2008. Accessed February 4, 2009.
Ferri FF. Ferri's Clinical Advisor: Instant Diagnosis and Treatment. St. Louis, MO: Mosby Inc; 2005.
Harden RN, Bruehl SP. Diagnosis of complex regional pain syndrome: signs, symptoms, and new empirically derived diagnostic criteria. Clinical Journal of Pain . 2006;22:415-419.
National Institute of Neurological Disorders and Stroke website. Available at:
http://www.ninds.nih.gov/disorders/reflex_sympathetic_dystrophy/detail_reflex_sympathetic_dystrophy.htm
. Accessed August 2005.
Reflex Sympathetic Dystrophy Syndrome Association website. Available at: http://www.rsds.org/ . Accessed August 2005.
8/10/2007 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Zollinger PE, Tuinebreijer WE, Breederveld RS, Kreis RW. Can vitamin C prevent complex regional pain syndrome in patients with wrist fractures? A randomized, controlled, multicenter dose-response study. J Bone Joint Surg Am. 2007;89:1424-1431.
11/9/2009 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Cacchio A, DeBlasis, E, Necozione S, di Orio F, Santilla V. Mirror therapy for chronic complex regional pain syndrome type 1 and stroke. N Engl J Med. 2009;361(6):634-636.
Last reviewed January 2010 by Rimas Lukas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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