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Complex Regional Pain Syndrome: Ongoing Neurological Pain

By HERWriter
 
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Complex regional pain syndrome. Reflex sympathetic dystrophy. Reflex sympathetic dystrophy syndrome. Sympathetic maintained pain syndrome. Causalgia.

These names have all been used at different times to describe a mysterious and disabling condition.

Complex regional pain syndrome (CRPS) is one of the contemporary labels most often used.

CRPS is believed to be a neurological problem. Nerve tissue has been damaged, and searing, ongoing pain is the result.

The initial trigger can be an event either large or small. The extreme trauma of surgery, a head injury, stroke or a heart attack, can lead to CRPS.

Residual pain after an experience of this magnitude does not seem too surprising. But even something seemingly so benign and prosaic as prolonged inactivity from bedrest, or wearing a cast or a splint, can be the cause.

There are two types of CRPS. Complex regional pain syndrome I seems to be caused by damaged tissue, with no apparent injury to any nerves. Complex regional pain syndrome II is triggered by a nerve injury.

Usually the disorder affects the arms and hands. It is less commonly found in the legs and feet.

CRPS elicits burning pain in the entire area. This pain remains at an extreme level that seems out of all proportion long after the stimulus for it has disappeared.

The skin is excruciatingly sensitive to the slightest touch and temperature change. It may be pale, blotchy, or dark red or blue, with a glossy sheen.

Stiffness, sweating and swelling (edema) often occur.

As the condition progresses, muscles waste away from lack of movement. They can become rigid, with the hands and fingers, or feet and toes, fixed in a contracted position.

Symptoms may spread to other parts of the body. If it started in one arm, it can travel to the other arm. CRPS can show up anywhere in the body, with no way of predicting its path or pattern.

Various therapies may offer some relief.

Application of heat and cold can reduce swelling and discomfort. Physical therapy may bring some flexibility and strength back to the affected muscles.

Transcutaneous electrical nerve stimulation (TENS) which is electrical current being applied to the skin, may lessen the pain.

Biofeedback encourages greater body awareness, so the individual can learn how and when to relax. This may lower the pain level.

If CRPS is diagnosed early on in its development, the severity of its symptoms may be reduced.

Resources:

emedicine: Complex Regional Pain Syndrome
http://emedicine.medscape.com/article/793370-overview

MedlinePlus -- Complex regional pain syndrome
http://www.nlm.nih.gov/medlineplus/ency/article/007184.htm

Complex Regional Pain Syndrome Fact Sheet
http://www.ninds.nih.gov/disorders/reflex_sympathetic_dystrophy/detail_reflex_sympathetic_dystrophy.htm

Complex Regional Pain Syndrome
http://www.mayoclinic.com/health/complex-regional-pain-syndrome/DS00265

Mirror Therapy for Chronic Complex Regional Pain Syndrome Type 1 and Stroke
http://content.nejm.org/cgi/content/full/361/6/634

In Complex Regional Pain Syndrome Treatment, More Pain Means Real Gain
http://www.medicalnewstoday.com/articles/170917.php

Visit Jody's website and blog at http://www.ncubator.ca and http://ncubator.ca/blogger

Add a Comment1 Comments

Thank you for writing about RSD/CRPS. While I am very happy to see an article about this syndrome, I will say there are some problems with this article. I have suffered with this disorder for more than 2 years. I refer to this disorder as the monster that invaded my life.

First, RSD/CRPS is a disorder of the central nervous sytem that manifests in the extremeties (arm and legs). The severity of the disorder is not related to the severity of injury. the injury can be as simple as a sprain to major trauma. It is a permanent condition. There are some cases of remission but these usually happen to the younger patients.

There are three types of spreads of the disorder, a continuous spread ( i.e. up or down a limb), mirror (i.e. right arm to left arm, left leg to right leg) or random (i.e. right hand to left leg). And it can affect the whole body. There is controversy over spreading, some doctors say yes and some say no. I have had two doctors at both ends of the spectrum. I know from personal experience that it does spread. My RSD/CRPS spread from my wrist up my arm to include the whole arm.

At the present time, treatment can include medication and physical therapy. There is no one standard treatment and treatment is very individualized. Physical therapy should be done by a therapist that has knowledge or experience with RSD/CRPS. Standard PT can injury a RSD/CRPS patient. No Pain is all gain for us.

One thing that I must say is ice is not considered safe, in fact the use ice on a RSD/CRPS limb will cause more damage to the limb.

There are four main symptoms; 1. Constant burning pain 2. Inflammation 3. Spasms-in muscles or blood vessels of the extremeties and 4. Insomnia/emotional disturbances (including changes to limbic system) Another very frustrating symptom is extreme sensitivity to touch, the air blowing across their skin or touch of fabric can bring a RSD/CRPS patient to tears. (This information is from RSDHope.org.) This is just a short list, it can affect a person in many other ways. I must add that not all patients exhibit all the same symptoms at the same time. This is part of the confusing side of this disorder.

This disorder is rated as the most painful disorder on the McGill pain rating scale.

This is a very old disorder going back thousands of years. It was documented during the Civil War. And even with this history it is relatively unknown in the medical community. This results in patients not being properly diagnosed, receiving the wrong treatments and patients being treated as druggies. To protect myself I carry information to share and inform other with.

You used some very good references but the best information I have found came from RSDhope.org, RSDSA.org, and rsdrx.com.

Reta

February 17, 2010 - 9:31pm
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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