Complex Regional Pain Syndrome

The majority of painful conditions a person might experience can be traced to a specific disease, ailment or traumatic, allowing for a definitive treatment plan. Unfortunately that is not the case for those who suffer from complex regional pain syndrome. This neurological syndrome causes not only painful symptoms that occur without reason, but also causes physical and sensory changes to the skin, most often in the extremities and especially the hand. The best way to find relief is to seek medical care as soon as possible. The California Pain Consultants team in the Escondido, El Centro, La Mesa, San Diego, and Chula Vista areas utilize the most state-of-the-art and technologically advanced treatments to provide patients with answers and relief. 

What is Complex Regional Pain Syndrome?

As the name suggests, complex regional pain syndrome (CRPS) is a condition that causes painful and debilitating sensory and physical changes to one specific area of the body. Experts believe that CRPS occurs as a result of dysfunction in your central or peripheral nervous systems that results in an overreaction to pain signals that the nervous system can’t shut off. 

Complex regional pain syndrome can occur without nerve damage, usually after an injury or illness. Or, it can occur after an instance of nerve damage. Most often, it is a result of a traumatic event that damages the arm or leg. Most common traumatic events include car accidents, deep wounds, surgery, infection and bone fractures. 

It is also known as Sudeck’s atrophy, causalgia, reflex sympathetic dystrophy (RDS), shoulder-hand syndrome, post-traumatic dystrophy, and reflex neurovascular dystrophy. The condition, caused by incorrect pain signals from being sent and recognized by the brain, ranks as one of the most common chronic pain conditions, above amputation and childbirth. 

What are the Symptoms of CRPS?

The symptoms of complex regional pain syndrome vary from person to person, but the one commonality is pain. The pain could be constant or intermittent, and could feel like a burning, stinging or tearing sensation, which feels like it’s coming from deep inside the affected limb. Sensory changes include increased sensitivity (hyperalgesia), feelings of pain from touch that would otherwise not cause pain (allodynia), and numbness. 

Other symptoms can include: 

• Changes in skin color (blotchy, pale, purple/bruised or red)
• Consistent throbbing or burning pain that lasts for at least three months
• Increased sensitivity to cold or pressure
• Skin swelling (can be intermittent or constant)
• Changes in skin temperature (affected limb is hotter or cooler than the other)
• Changes in hair or nail growth (no growth or rapid growth)
• Decreased function in affected limb (increased stiffness and joint immobility)
• Muscular spasms
• Muscular atrophy (i.e. loss of muscular tone or strength)
• Changes in skin texture (skin may become shiny, thin, or excessively sweaty)

While all these symptoms might not be present, most individuals report feeling the majority of the aforementioned symptoms. 

Women experience complex regional pain syndrome more often than men, and emotional distress has been shown to increase the severity of the symptoms. It’s important to seek medical help as soon as the symptoms appear as it’s easier for providers to diagnose and treat in the early stages. If left untreated, some of the symptoms can be irreversible. 

How is Complex Regional Pain Syndrome Treated?

The goal of treatment is to decrease pain and associated symptoms, restore function to the affected limb, and maintain the patient’s quality of life. It’s important to begin treatment methods as soon as possible because the affected limb will only become more stiff and treatment more painful. The most common treatment methods include: 

• Physical therapy: helps to improve range of motion and strength with a goal to decrease functional limitations in the affected limb
• Biofeedback: training patients to recognize and identify when pain symptoms are felt and respond with learned techniques to provide pain relief
• Alternative healthcare: acupuncture, chiropractic care and massages provide both pain relief and help to promote normal functioning of the affected limb
• Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) help to relieve pain and reduce inflammation
• Nerve blocks: a stellate ganglion block, brachial plexus nerve block, and lumbar sympathetic nerve block help to provide relief from pain felt in the affected limb by blocking the pain sensations from reaching the brain
• Infusion techniques: the placement of local anesthetic and other medicines in the epidural space or next to damaged nerves with the goal to block nerves and provide lasting pain relief
• Spinal cord stimulation: small electrodes implanted in the epidural space release an electrical current that replace pain sensations from being received by the brain
• Peripheral nerve stimulation: much like spinal cord stimulation, this technique delivers mild electrical currents directly to peripheral nerves outside the spinal cord, which run from the spinal cord to the limbs or organs in the body, effectively treating chronic pain

What Can I Expect with CRPS?

Each person’s experience with complex regional pain syndrome and, thankfully, most experience pain relief with treatment and a complete reduction of symptoms if treatment was effective and began early enough. However, for patients with severe cases or those who don’t seek treatment as soon as possible, there are instances where CRPS has gotten worse and moved into another area of the body. Adding in any intense psychological distress can also worsen the syndrome. 

The most important goal for the pain management specialist is to provide treatment that relieves pain and restores mobility and function to the affected limb so that the patient can enjoy both a heightened quality of life and reduce the symptoms associated with the syndrome. 

If you believe you are dealing with symptoms of complex regional pain syndrome, or think you might be experiencing the onset of symptoms, it’s important to schedule an appointment with a trained pain management specialist who can accurately diagnose and expertly treat both your symptoms and the syndrome itself. The California Pain Consultants team in the Escondido, El Centro, La Mesa, San Diego, and Chula Vista areas is dedicated to helping their patients beat the damaging symptoms of complex regional pain syndrome and enjoy a pain-free life.