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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.
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
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
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.