What is complex regional pain syndrome (CRPS)?
Complex regional pain syndrome (CRPS) is the new name for what was previously known as post-traumatic dystrophy, Südeck dystrophy, or sympathetic reflex dystrophy. A distinction is made between CRPS without nerve damage (type 1) and CRPS with nerve damage (type 2). CRPS usually affects the arms and legs.
The cause of CRPS is unknown. There are various thoughts on its development. Some specialists believe it to be over-sensitiveness of the nervous system. Others believe there is an abnormal inflammatory response. It can occur after a fracture of the arm or leg, or after limb surgery, but occasionally it occurs spontaneously.
The disease process can proceed in several ways. Typically, CRPS occurs after minor injury to an arm or leg, with the symptoms being similar to significant inflammation of the limb in question. The area surrounding the injury is swollen, red, hot (or cold) and, in particular, very painful. Moreover, changes occur in hair and nail growth, sweat patterns change, and/or the affected hand or foot starts to cramp. Over time, the pain often becomes worse. The affected limb slowly stiffens and decreasing sensation can occur. This can lead to loss of function of the affected limb. The course of the disease varies greatly between patients. Some patients incur few problems and experience rapid and complete recovery. In others, the disease can become very serious with little improvement and severe permanent disability.
How is the diagnosis made?
One of the major problems with CRPS is that there are no diagnostic tests available to confirm the diagnosis. There are no blood examinations, special x-rays, or scans for the diagnosis of CRPS. Diagnosis can only be made on the basis of symptoms and on any abnormalities seen at the time of the physical examination.
Do I need any additional examinations?
- Diagnostic examination for other non-physical factors important for your pain, have already been done by yourself trough filling out your pain questionnaires.
- No blood examinations, special x-rays or scans will be necessary, unless a different diagnosis is suspected.
What are the treatment possibilities?
Depending on the cause of your pain, your pain specialist will decide on whether or not to embark on physical treatment. Based on the results of the completed pain questionnaire, additional examinations can be carried out and, as well as physical treatment, other methods of treatment will be suggested.
If the results of your pain questionnaire are abnormal, your pain specialist will suggest one of the non-physical treatments listed below:
- Psychological Treatment
- Depression Treatment
- Cognitive-Behavioural Treatment
- Rehabilitation Treatment
Interventional Pain Treatments
- ganglion stellatum test block (arm)
- ganglion stellatum block (arm)
- lumbar sympathicus test block (leg)
- lumbar sympathicus block (leg)
- Spinal cord test stimulation
- Spinal cord stimulation