Complex regional pain syndrome (CRPS) is a multi-systemic, chronic pain condition that usually develops following trauma or injury to a limb. It affects the lives of approximately 5,000 Australians every year and causes significant challenges in everyday life. 

CPRS can present in both acute, and chronic forms. Within this article, we’re going to delve into the causes, symptoms, and treatment options for CRPS. 

What causes complex regional pain syndrome?

Complex regional pain syndrome is known to develop following an injury to an arm or leg.

Currently, no singular cause has been identified as bringing about CRPS, but it is believed to be linked to a nervous system dysfunction. Following trauma or injury to a limb, the nerves send incorrect signals to the brain, causing both pain and discomfort in the area.

There are several possible triggers, such as nerve and tissue damage, but there are also many spontaneous cases of CRPS with no identified reason or cause.

Risk factors for developing CRPS

• Injury or Trauma: CRPS has been known to develop following a trauma or injury to a limb, such as a fracture.
• Damage: In over 90% of cases, CRPS results from nerve trauma to the affected limb.
• Age: Although CRPS can occur at any age, it is rare in children and adolescents. People over the age of 50 have increased vulnerability to developing CRPS.
• Gender: CRPS is more prevalent in women than men.
• Surgery: Particular types of surgery, such as an amputation or fracture fixation, can increase the risk of developing CRPS.

Complex regional pain syndrome symptoms 

• Swelling: The impacted limb may become tender and swollen, making it stiff and difficult to move.
• Muscle weakness and spasms: The affected limb may experience involuntary muscle contractions and weakness, causing difficulties with movement.
• Pain: Pain associated with CRPS is often described as a constant and severe burning sensation, which is often localised but can also spread to other body parts. The skin in the affected area can become very sensitive, with even the slightest touch, bump or change in temperature can cause intense discomfort.
• Changes in skin colour and temperature: The skin may become discoloured and appear pale, purple, red,or bluish. The affected limb may also feel warmer or cooler than the surrounding skin.
• Changes in skin texture: The skin may develop a mottled appearance and become thin or shiny, as well as itchy and dry. 

How is CPRS diagnosed?

Unfortunately, there are currently no specific tests designed to assess and diagnose CRPS, as symptoms can vary widely between different people. A diagnosis is typically made based on a physical exam, medical history, symptoms, and the ruling out of other possible conditions or illnesses. This can make the process of CPRS diagnosis quite a lengthy, drawn out, and frustrating process as there are still so much unknown about the condition. 

Can CPRS be treated? 

Yes – there are ways in with complex regional pain syndrome can be effectively managed and treated! The main goal of CRPS treatment is to improve function, relieve pain, and prevent worsening symptoms. Treatment usually involves medication in conjunction with physical therapy through physiotherapy, occupational therapy, and hand therapy.

Medication

To help manage pain, medications such as anti-inflammatories may be prescribed to those suffering from CRPS. Topical or oral anti-inflammatories have been proven effective for improved function and pain relief. Moreover, antidepressants or anticonvulsants may also be prescribed to aid in managing other symptoms that often accompany the more common symptoms of CPRS.

Therapies

Occupational therapy, hand therapy, and physiotherapy can be beneficial for CRPS. Physical therapy will work to improve strength, range of motion and flexibility in the weakened limb, as well as reducing swelling and pain.Modalities such as biophotomodulation (red light therapy) and InterX Therapy (non-invasive electrical intervention) can further assist with pain reduction.  Therapy can also assist with identifying strategies  to improve quality of life and the manage symptoms of the condition. These include: 

• Exercise: Keep moving the affected limb, even though it may be painful. This can help to prevent muscle stiffness and weakness.
• Relaxation Techniques: Practicing deep breathing, yoga, or meditation can aid in the management of pain, as stress often makes the pain worse.
• Sleep Patterns: Establishing a regular sleep routine and creating a comfortable sleeping environment can assist in managing pain levels.
• Healthy Diet: Healthy foods can reduce inflammation, improve energy levels, and help maintain a healthy weight.
• Support System: Seeking support from friends, family, or other support groups can significantly help cope with the condition, as living with CRPS (and any other chronic pain condition) can be challenging and isolating. 

Surgical Options

In more severe cases of CRPS, surgery may be needed to relieve pain, if other treatments are ineffective. However, it is strongly advised that all other pain management and treatment options should be exhausted before a complicated, invasive, and life-changing procedure, such as amputation, is considered.

Wrapping up

Complex regional pain syndrome is a severe chronic primary pain condition that requires early  diagnosis and intensive treatment. It is a syndrome affecting the sociological, psychological, and physical aspects of health, and it can lead to a rapid decline in a person’s quality of life.

While a single cure for CRPS is yet to be discovered, many different treatment options enable affected individuals to improve their overall well-being and manage their symptoms effectively. Accurate diagnosis and treatment plans developed alongside healthcare providers should be tailored to your specific symptoms for you to get the most out of life.

Apricus Health are Townsville’s leading allied health professionals. As a team of hand therapists, occupational therapists, and physiotherapists,, we have the required skill, knowledge, and compassion required to manage such a complicated and challenging condition. If you’d like to learn more about how our team can help with your CPRS diagnosis or treatment, get in touch with us today.