Complex Regional Pain Syndrome Treatment

Overview

CRPS, abbreviated as Complex Regional Pain Syndrome, is a disorder causing certain clinical conditions, chronic pain being the primary one. This form of chronic pain typically affects the arms and legs and is of two types – Type I CRPS and Type II CRPS. Type I CRPS occurs due to trauma, while Type II CRPS is caused by nerve injury in the limbs, stroke, surgery, and sometimes even heart attack.

Several terms such as – Reflex Sympathetic Dystrophy, Algodystrophy, and Causalgia have been used for this chronic pain condition. However, since 1995, Complex Regional Pain Syndrome has been used as the standard term. It is important to see your doctor if you feel any symptoms, as CRPS can be treated if detected early. Feel free to call us to fix an appointment with our specialists.


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Complex Regional Pain Disorder: Signs & Symptoms

Symptoms, however, can vary from individual to individual. It’s crucial to identify the condition at the right time. When one begins to see symptoms such as the affected limb getting pale and changes in the nail & skin, the condition becomes irreversible.

One may spot CRPS by the following signs and symptoms:

  • Continuous burning pain in the limbs – arm, leg, hand, and foot
  • Noticeable change in the temperature of the affected area
  • Sensitivity to cold and touch
  • Swelling and inflammation in the affected area
  • Changes in skin and nail
  • Stiffness or swelling of joint
  • Sensory disturbances such as strange or dislocated feelings in the limbs
  • Inability to effectively move the affected body part
  • Alterations in skin temperature from sweaty to cold
  • Alterations in skin color – changing from white to red and blue
  • Weakness, muscle spasms, and cramps
  • Sleep deprivation due to the enormous pain
There have also been cases where CRPS spreads from one limb to another. Hence it’s important to get it treated at the correct time.
Complex Regional Pain Syndrome

What Are The Causes?

It is hard to state one specific cause of Complex Regional Pain Disorder. However, typically, CRPS occurs due to a trauma or an injury to the arm/leg and even due to abnormalities in the nervous system.
  • Type I CRPS can occur due to illness and an indirect injury in the limb
  • Type II CRPS occurs as a result of direct injury to the nerves
Surgeries, heart attacks, ankle sprains, and even infections may cause Complex Regional Pain Syndrome. However, not all such cases would compulsorily lead to CRPS, and that is why to date, there’s no specific explanation as to how certain injuries cause CRPS.  

When to See a Doctor?

It is important to note that the cure of any disorder or condition depends on how early it has been detected. Likewise, it’s vital to detect and treat complex regional pain or regional sympathetic dystrophy syndrome early to get the best results.
  • It’s best to see a specialist as and when
  • You experience constant severe pain in the limbs
  • The constant change in temperature of the affected area
  • Swelling, redness, and hypersensitivity in the affected area
  • Difficulty in moving the affected limb
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Complex Regional Pain Syndrome Diagnosis

Diagnosis for CRPS is done depending on its history and present state. However, detecting the CRPS of RSD depends on the patient’s physical exam and medical history. It can’t be diagnosed using a single test, but multiple procedures might help shed light on the condition. Your doctor might order the following tests to determine the disorder:

Dynamic Phase Bone Scan

A dynamic phase bone scan may help monitor changes in the bone. The test is done by injecting a radioactive substance in the patient’s veins that can be seen through a special camera.

Sweat Production Test

This test is done by measuring the amount of sweat produced on both limbs. In case of uneven results on each limb, CRPS is suspected.

Magnetic Resonance Imaging

MRI is an imaging test that can help detect any changes in tissues of the limbs that CRPS could cause.

X-Ray

CRPS causes loss of minerals from the bones of the affected limbs. X-rays, a diagnostic test, can help detect bone mineral losses.

Prevention

There’s an age-old phrase, “prevention is better than cure” while it may not always be humanly possible to stop the inevitable, one can always take certain preventive measures to help in avoiding CRPS.

The following may help in reducing the chances of CRPS:

  • Vitamin C after a Wrist Fracture – High dose of vitamin C post wrist fracture is proven to lower the chances of getting CRPS.
  • Mobilization – Remaining bedridden even after recovering from a stroke can cause more harm than good. Hence early mobilization, i.e., resuming movements and walking after recovering from the stroke, reduces the risk of CRPS.

Treatment At Padda Institute

CRPS or RSD can be treated if diagnosed early in the first six months to a maximum of 2 years. Padda Institute center for interventional pain management offers long-term relief procedures.

There is a limited application for surgical sympathectomy procedures (removing part of the chain of sympathetic ganglia on the side of the spine) in the treatment of RSD. The treatment options include sympathetic blocks with regional anaesthetic techniques, radiofrequency thermoneurolysis, or neuromodulation with spinal cord or peripheral nerve stimulation.

The radiofrequency neurolysis method provides added safety to a continuous regional sympathetic or neurolytic block in providing long-term relief. The purpose of sympathetic blocks is to facilitate the management of CRPS with analgesia and functional restoration along with simultaneous sympatholysis to provide unambiguous evidence of sympathetically maintained pain. After sympatholysis is found to be effective in reducing both the burning dysesthesia and the allodynia or hyperalgesia, it is important to repeat the procedure to see if the duration of the effects becomes longer for any particular patient. These individual blocks may be all that is necessary for a patient to regain their abilities. If sympatholysis effectively relieves symptoms and facilitates exercise therapy, but its duration is limited, a radiofrequency neurolysis block may be an option.

The application of radiofrequency has been described for lesioning the cervical sympathetic chain, the thoracic sympathetic chain, and the lumbar sympathetic chain, as well as for treating neuropathic pain in CRPS I and II.

Experts at Padda Institute

Padda Institute has one of the most experienced specialists for complex regional pain syndrome (CRPS) or reflex sympathetic dystrophy (RSD) in St. Louis & the Bridgeton area. We work together as a team to ensure the patient’s successful recovery.

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