CRPS - Complex Regional Pain Syndrome

What is complex regional pain syndrome?

CRPS is believed to be caused by damage to, or malfunction of, the peripheral and central nervous systems.  CRPS is characterised by prolonged or excessive pain and changes in skin colour, temperature, and/or swelling in the affected area.

CRPS is divided into two types:  CRPS-I and CRPS-II. Individuals without a confirmed nerve injury are classified as having CRPS-I (previously known as reflex sympathetic dystrophy syndrome).  CRPS-II (previously known as causalgia) is when there is an associated, confirmed nerve injury.

 

Who can get CRPS?

It is more common in females, CRPS can occur in anyone at any age, with a peak at age 40.  CRPS is rare in the elderly. Very few children under age 10 and almost no children under age 5 are affected. 

What are the symptoms of CRPS?

The key symptom is prolonged severe pain that may be constant.  It has been described as “burning,” “pins and needles” sensation, or as if someone were squeezing the affected limb.  The pain may spread to the entire arm or leg, even though the injury might have only involved a finger or toe. In rare cases, pain can sometimes even travel to the opposite extremity.  There is often increased sensitivity in the affected area, known as allodynia, in which normal contact with the skin is experienced as very painful.

People with CRPS also experience changes in skin temperature, skin colour, or swelling of the affected limb.  This is due to abnormal microcirculation caused by damage to the nerves controlling blood flow and temperature.  As a result, an affected arm or leg may feel warmer or cooler compared to the opposite limb.  The skin on the affected limb may change colour, becoming blotchy, blue, purple, pale, or red.

Other common features of CRPS include:

  • changes in skin texture on the affected area; it may appear shiny and thin 

  • abnormal sweating pattern in the affected area or surrounding areas

  • changes in nail and hair growth patterns

  • stiffness in affected joints

  • problems coordinating muscle movement, with decreased ability to move the affected body part

  • abnormal movement in the affected limb, most often fixed abnormal posture (called dystonia) but also tremors in or jerking of the limb.

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