Chronic Pain Treatment -Complex Regional Pain Syndrome

Complex Regional Pain Syndrome

Complex regional pain syndrome (CRPS) is an uncommon nerve disorder, and the cause of this syndrome is not well understood. The intense pain typically affects one of your extremities or your feet. If you suffer from this type of pain it typically follows some type of serious injury. The pain is much more extreme than you would expect following such an event.

The most common symptoms are an intense burning pain in the affected area, extreme skin sensitivity and a dramatic change in the temperature and color of your skin. The most common age range for this condition is 25-55 years old, and CRPS is three times more likely to happen to women. Anywhere from 3 to 6 million Americans suffer from this syndrome.

Severe CRSP

Hand Contracture; Photo Whickipedia
Hand Contracture; Photo Whickipedia

More Serious Chronic Regional Pain Symptoms

Improvement in your pain or remission is possible, but treatment is difficult without an understanding of the cause. According to Mayo Clinic other typical symptoms include:

  • Swelling in the area of pain.
  • The skin may turn different colors, from white to a mottled red or blue. This is similar to Raynaud’s Disease.
  • Changes in the texture of the skin may occur. The skin may become tender, shiny or thin in the painful areas.
  • The hair or nails may grow too fast or too slow.
  • Stiffness, swelling or damage to a joint is not uncommon.
  • Muscle spasms may occur, then weakness and eventually atrophy.
  • There may be a decreased ability to move the affected area of the body.

If this syndrome continues, the other symptoms listed above occur, and then the condition is usually irreversible.

There are times when this chronic pain syndrome leaves on its own, without treatment. If treatment is started early in the course of this syndrome, there is an improved chance of recovery.

Types of Complex Regional Pain Syndrome

Complex pain actually has two types. Approximately 90% of the people with this syndrome have Type 1, which is known as reflex sympathetic dystrophy syndrome. Type 1 occurs after an injury or illness that did not actually damage a nerve in the affected limb.

Type 2, causalgia, has distinct nerve damage. This type may occur after a traumatic or crushing injury, and it sometimes occurs after an amputation. It can also happen after a heart attack, a stroke, an injection, surgery or even a sprained ankle. Emotional stress can also impact this syndrome.

It is thought that the cause of this condition is due to dysfunction between the central and peripheral nervous systems, thus it is an inflammatory response. Some of the worst case scenarios include a muscle contracture, which you see quite often after strokes. It may also cause tissue wasting. If you have an extremity that is extremely painful you tend not to move that extremity, so the muscle is not being used. Eventually, you will experience stiffness in the muscles, along with the skin and bones.

How is the Diagnosis Made?

There is no simple test that will confirm this diagnosis. When you present to the doctor with the above symptoms, the most common tests ordered are a bone scan, an MRI, X-rays and Sympathetic Nerve System tests.

Injection for Ganglion Nerve Block


Pain Treatment

When treatment is started within a few months of the first symptoms, you will likely improve and remission is possible. Treatment depends on the severity of the symptoms. Treatment is focused on relieving the pain. Pain relievers may be over-the-counter medications that are anti-inflammatory, such as Aleve or ibuprofen. Sometimes antidepressants or medications that treat seizures are used to treat a damaged nerve. Steroids are also used to reduce inflammation, which will improve mobility. Sometimes the affected area will be injected with an anesthetic to block pain fibers in the affected nerves if warranted.

Other types of treatments that may be used are applying heat or cold. Topical analgesics, such as lidocaine, may help reduce the hypersensitivity. Physical therapy may also be helpful.Transcutaneous electrical nerve stimulation (TENS unit) may relieve your pain, as it sends little electric signals to nerve endings. Biofeedback will teach you to become more aware of your body and enable you to relax your body, which will relieve the pain. Finally, spinal cord stimulation is used. This is where tiny electrodes are inserted along the spinal cord, which sends a small electric current to the spinal cord and effectively relieves the pain.

If a nerve is compressed, sometimes surgery will relieve the problem. Many people go to a pain clinic to find relief for their pain.

Tens Unit Electrode Placements


Coping with Chronic Pain

Chronic pain is much more difficult to endure than acute pain due to its persistence. Different people have various emotional responses to the intensity of pain and different thresholds of pain tolerance as well. Sadness is certainly common and depression may set in also. If you become hopeless, this is self-destructive. If chronic pain endures over a long period of time it is not uncommon to go through the grief process, as you are now dealing with the realization that your life has forever changed. That type of change is difficult for most people. CRPS tends to have a profound psychological effect on the patient on the family.

Complex Regional Pain Syndrome

In Conclusion

Living with chronic pain not only affects you, but also the loved ones around you. It is very important to have support from your family and friends. If you can reach a point of acceptance, this will benefit you in many ways. You will be able to better adjust to your limitations and perhaps find things to keep your interest that are physically possible to accomplish. It is important to ask questions of your doctor and be involved in your plan of care. This will help you feel like you have more control over your life.

The National Institute of Neurological Disorders and Stroke (NINDS) is currently doing research on chronic pain that involves the brain and nervous system. There is certainly more research necessary for complex regional pain syndrome. Chronic pain management is unique to each individual.

© Copyright May, 2012 by Pamela Oglesby .Unauthorized use and/or duplication of this material without express and written permission from this author and/or owner is strictly prohibited.

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Comments 26 comments

joanveronica profile image

joanveronica 4 years ago from Concepcion, Chile

This was very interesting, I must study it further! It just could be possible I have some of the characteristics! This would answer several mysteries in my life of pain. Very interesting, well written Hub. Voted up, useful and interesting

JY3502 profile image

JY3502 4 years ago from Florence, South Carolina

Very interesting article Pam. Some good information and well written. But check your copy one more time.

Pamela99 profile image

Pamela99 4 years ago from United States Author

joanveronica, I'm glad the hub was helpful to you. I know it is difficult to live with chronic pain. I appreciate your comments.

Pamela99 profile image

Pamela99 4 years ago from United States Author

JY3502, Thank you for your comments advice. I shouldn't post a hub at 4:30 AM when I can't sleep!

anglnwu profile image

anglnwu 4 years ago

Lots of facts regarding Complex Regional Pain syndrome. I have not heard of it but am glad to be able to learn from the best. Thanks and rated up.

Pamela99 profile image

Pamela99 4 years ago from United States Author

This is rare, but I think it always good to be aware of medical issues. I appreciate your very nice comments.

skye2day profile image

skye2day 4 years ago from Rocky Mountains

Pamela99 No mistake I landed here girl. Yikes my hip and low back over a period of several months has increased in pain. As much as I am praying this is not so many of the symptoms are close to identical. I will keep praying sister!! God is not short of miracles. I am grateful to have landed here. Know this has helped me to gain some understanding.

Your writing is very good and flows right along. You done good for 4:30 AM (0; You could be writing in medical journals. TEE HEE Thank you sister for a ton of great info. Love ya.

mwilliams66 profile image

mwilliams66 4 years ago from Left Coast, USA

A very interesting and educational hub. It's wonderful that you are taking the time to raise awareness.

Pamela99 profile image

Pamela99 4 years ago from United States Author

sky2day, I agree that God is surely not short of miracles. I sure hope you receive one, then your pain will be relieved. I appreciate your sweet comments, not to mention the compliments. Love ya back.

Pamela99 profile image

Pamela99 4 years ago from United States Author

mwilliams, I like to write articles to raise awareness, as so many people have undiagnosed diseases anymore. Having had that experience in my lifetime gives me an incentive to write. Thank you for your comments.

Just Ask Susan profile image

Just Ask Susan 4 years ago from Ontario, Canada

Pam, I was just about to do a hub on this and as I was putting in the title, it would not let me have it. So I did a search and found your hub. When I fractured my fibula bone back in October the end result was CRPS. To make a long story short I've been having acupuncture along with physio therapy. It has gotten better than it was but I still have a long way to go. If you don't mind I'd like to add a link to a hub I wrote because you've explained this condition so well.

Up, and very useful!

Pamela99 profile image

Pamela99 4 years ago from United States Author

Susan, I don't mind at all. I'm sorry to hear you have been going through this as it certainly sounds painful. I'm glad it is better and I appreciate you sharing your experience.

teaches12345 profile image

teaches12345 4 years ago

I know people who have to live with pain and have electrode treatments on a monthly basis. It is something they live with, but I wish they didn't have to do so. Thanks for education on chronic pain treatments.

Pamela99 profile image

Pamela99 4 years ago from United States Author

teaches, It is so difficult for people living with that type of pain and I wish no one had to suffer like that. Thanks for your comments.

always exploring profile image

always exploring 4 years ago from Southern Illinois

This is very interesting and helpful. I know people who live with chronic pain, hopefully this will help them. Thank's for sharing. Your research on this is outstanding.

Pamela99 profile image

Pamela99 4 years ago from United States Author

Ruby, I hope this hub will help them also. Thank you so much for your comments.

Rosemay50 profile image

Rosemay50 4 years ago from Hawkes Bay - NewZealand

I hadn't heard of this before but you have done a wonderful job of providing the information and making people aware of CRPS. I am sure there are those who will identify with this and find answers they were looking for.

Interesting and useful

Pamela99 profile image

Pamela99 4 years ago from United States Author

Rosemary, This is rare but so often rare diseases go undiagnosed, so I thought this was a good topic. Thank you so much for your comments.

Lord De Cross profile image

Lord De Cross 4 years ago

Completely useful; was wondering if statistics from war veterans can point to this Chronic pain syndrome. Now we wonder, again, if back on the days of Charlemagne (850 A.D) or Napoleon (1815) the Human complexity of pain and diagnosis... was similar, or in earlier chronic stages that evolved with us as society..?

Pamela99 profile image

Pamela99 4 years ago from United States Author

lord de cross, There is a 12 week program for Vets suffering from PTSD and chronic pain, which teaches teaches soldiers to re-introduce activities as tolerated and they are taught relaxation techniques also. I never found any statistical information about for vets and chronic. You ask some good questions about history and how the pain might have evolved. I would like to know also. I appreciate your comments.

donnaMhicks 4 years ago

Outstanding hub! I have arthritis in both feet and Raynauds, with symptoms much worse in left foot. My docs in the past have been the kind who treat you like you're stupid and after telling them the symptoms/issues, they say something like "here's your appointment slip to come back in 90 days - see you then." Doc gets paid for nothing and patients still suffer and have no clue what to do. Hopefully, the "specialized ortho" doc I see next wk will be better; I'll be armed with info from this hub. Thanks much-voted up!

Pamela99 profile image

Pamela99 4 years ago from United States Author

donnaMhicks, You might also consider seeing a rheumatologist if this doctor doesn't work out. The problem is there are no good medications that treat the problem, only the symptoms. I recently started talking Cymbalta for burning pain is my feet, legs and hands and it took a little over 2 weeks for it to ease the pain, but now things are better. I don't know if that would help you, but I hope this new doc helps. Thanks for your comments and let me know if you like the new doctor.

kims3003 4 years ago

One of the best I have seen written about this condition!!

Pamela99 profile image

Pamela99 4 years ago from United States Author

Kims, I very much appreciate your comments.

Majidsiko profile image

Majidsiko 3 years ago from Kenya

Thanks for this ypu wirte very insightful hubs. These pain syndromes are very difficult to diagnose. I have seen patients being treated as psychiatric patients when doctors can't figure out what's going on. They can be quiet debilitating.

Pamela99 profile image

Pamela99 3 years ago from United States Author

Majidsiko, That is a shame as the people with this pain really suffer. Thanks for your comments.

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