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
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