Complex regional pain syndrome (CRPS) may cause much distress. These pains are difficult to cure since no single treatment may work for all. However, there is an encouraging news, too. Most of those experiencing CRPS would recover from the condition, though it may take months and even years.
CRPS may occur anywhere in the body, but it is more likely to affect limbs. There are two kinds of CRPS. CRPS-1 occurs secondary to some physical injury or illness causing nerve injury. CRPS-2 occurs due to damage to a specific nerve.
The condition is not just painful but also difficult to diagnose. Since, in most cases, there is pain without any signs of inflammation. It also causes an increase in local skin temperature. However, many may suffer from so-called cold CRPS.
The issue with the condition is that it causes severe pain in many without any visible injury. Other symptoms like swelling, redness, and local warmth may be present. Further, symptoms tend to change over time.
Most people will develop short-term CRPS lasting for a few months, and most will recover within a year. However, for some individuals, it is a cause for constant or chronic pain. It appears that young adults are more likely to recover faster from the condition. In contrast, older adults may need regular treatment for their pain.
Identifying CRPS
CRPS has different symptoms in different patients. Quite often, pain would start suddenly, and it may be constant or even worsen with activity. It may be a burning sensation or “pins and needles.” Some also experience “mirror pain,” which may indicate the involvement of spinal neurons.
The pain is often long-lasting, and people living with the condition are very sensitive to painful stimuli. They experience so-called allodynia, which means that in many cases, even slight touching may cause severe pain.
Other symptoms of the condition are changes in skin temperature, color, and swelling of the affected limb.
However, in the condition, more severe changes may also occur. Thus, there is a thinning of bone in many, while others may experience excessive bone growth visible in X-rays.
In the long run, CRPS may also cause the weakening of the muscles since those affected by the condition are less likely to engage in physical activities.
Though CRPS may occur in anyone, it is more likely to occur in females and those above 40. It is also more likely to occur secondary to fractures, surgical procedures, sprains, and strains, burns and cuts, and so on.
Treatment Options
Diagnosing the condition is a bit challenging. However, doctors or chronic pain specialists are often able to identify it based on some typical signs and symptoms, such as abnormal pain sensations and changes in skin color and temperature.
Complex Regional Pain Syndrome (CRPS) is best managed with early intervention. Since there are no treatment guidelines, doctors would often need to combine multiple methods to overcome this chronic pain syndrome. Response to different treatments may vary among the patients.
Physical therapy and rehabilitation are the cornerstones of treatment. Keeping the affected limb or body part moving is crucial as it enhances blood flow, reduces symptoms, and maintains flexibility, strength, and function.
Additionally, wearing compression garments can significantly reduce swelling, particularly when standing. These simple behavioral changes are essential in managing CRPS symptoms effectively.
Psychotherapy is another vital component of CRPS treatment, as secondary psychological issues such as depression, anxiety, and PTSD are common among patients and can exacerbate pain.
Medication management is also a critical aspect of CRPS treatment. Although no medications are specifically approved by the FDA for CRPS, various drugs can help manage symptoms. Acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to alleviate pain and inflammation. Medications for nerve pain, such as nortriptyline, gabapentin, pregabalin, and duloxetine, can be effective, along with topical treatments like lidocaine and fentanyl patches.
In more severe cases, bisphosphonates for bone changes, corticosteroids for inflammation, opioids for extreme pain, and botulinum toxin injections for muscle relaxation may be considered.
Doctors might need to use advanced techniques, such as spinal cord stimulation, involving implanting electrodes near the spine to block pain signals. Other neural stimulation methods, including transcranial magnetic stimulation (rTMS) and deep brain stimulation, provide alternative options for managing CRPS pain. Spinal-fluid drug pumps, which deliver pain relief directly to the spinal cord, offer another advanced treatment by minimizing systemic side effects and enhancing drug effectiveness.
To summarize, CRPS may be challenging to treat, but a cure is possible. Most would recover within the year. Few might need longer medical care.
