What is Complex Regional Pain Syndrome (CRPS)?
Complex Regional Pain Syndrome (CRPS) is also known as Reflex Sympathetic Dystrophy (RSD) and Causalgia and is thought to affect around 12,000 people in the UK, with over two thirds of them being women. The condition is more likely to develop in the patients mid forties but it is now becoming more common in children than was previously thought.
The illness was first recognised in the Civil War but the exact cause still remains a mystery.
CRPS is a chronic pain condition which often, but not always occurs after an injury.
CRPS is often suspected if the patient complains of pain which is totally out of proportion to the original injury and although there is no test to accuratly determine CRPS, scans, X-rays, MRI's and blood tests are often conducted to help rule out other conditions.
It is quite often the case that the patient will have seen several doctors before reaching a final diagnosis. Specialist Pain Management Units are more likely to make a relatively quick diagnosis and it has been shown that those who go into remission are more likely to have been diagnosed within the first 3-6 months of the onset of symptoms.
Whilst a person cannot be truly cured of CRPS the condition can go into remission for periods of time.
What are the Symptoms of CRPS?
There are many symptoms of CRPS and it differs in each indiviual however the most common symptoms are:
- Excrutiating Pain that is out of proportion for the injury (the pain may be burning, stabbing, shooting, tingling etc)
- Swelling
- Colour and Temperature Changes
- Muscle Spasms / Movement Disorders
- Hair and Nail Growth Changes
- Lesions
- Increased Skin Senstivity (where even the slightest touch can cause extreme pain)
- Stiffness in affected limbs
What Causes CRPS?
Doctors don't fully understand what causes CRPS however it is thought that it occurs when the bodies Sympathetic Nervous System fails to react in the normal way after an initial injury has begun to heal.
To explain, think about dropping something on your foot. Straight away the pain becomes quite severe, you may have redness or bruising and the area might become swollen and tender to the touch. These are all normal reactions to an injury that are governed by your Sympathetic nerves which send messages to your brain telling your body how to react to protect itself from further harm. Eventually as the injury subsides the pain lessens, the redness goes away and any swelling will begin to subside.
In a person with CRPS, the mechanism which tells the brain that an injury is healing develops a fault. Instead of telling the brain that things are getting better, the sympathetic nerves send messages telling the brain that things are getting worse, hence the increases in pain, sensitivity etc.
Is CRPS Psychological?
Often, when doctors discuss CRPS with patients, they talk about messages going to the brain and the bodies protective mechanism in response to an injury. It is extremely important that sufferers understand that the reaction of the nervous system in CRPS is entirely out of their control. There is nothing a person can do to make the reactions happen although they often believe that doctors think this is the case.
Some of the mix up comes in the way in which doctors explain complex reactions within the nervous system to people who have no medical training.
CRPS can, however, have Psychological side effects such as Depression and Anxiety as the sufferer will often get frustrated that they can't do things that they previously could.
What is the treatment for CRPS?
Unfortunately, there is currently no cure for CRPS. Symptoms CAN be managed though by treatments such as Physiotherapy, Occupational Therapy, Pain Medications, Nerve Blocks, Spinal Cord Stimulators, Intractable Pain Pumps etc.
Every indiviual with CRPS is different and that makes it hard for Doctors to determine what therapy and/or medications will work for you. What works for one person suffering from CRPS might not work for another unfortunately. It can often take a long time to find a treatment that will work for you but please, do not give up hope because there will probably be something out there that will work for you - it is just a matter of finding it!!!!
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Royal Childrens Hospital Petition - Please Sign - Girl refused treatment as 'too old' for their CRPS Pain Management Program!