Complex regional pain syndrome, also known as CRPS pain or reflex sympathetic dystrophy syndrome (RSD), is a condition of an unusually high degree of pain. CRPS pain can be the product of an injury or medical issue such as a surgical procedure or stroke. However, the pain experienced is atypical in nature and is longstanding or chronic in nature.
Frequently affecting the arms or legs, CRPS pain is thought to be caused by a miscommunication between the central nervous system — which consists of the brain and the spinal cord — and the peripheral nervous system, consisting of the nerves traveling throughout the body. There are two types of CRPS pain. Type I precedes an injury but does not directly injure the nerves affected by this pain syndrome. Type II, also known as causalgia, is the result of a direct injury to a nerve.
The problems from CRPS pain can vary from changes in sensations, temperature and coloring to swelling, weakness, stiffness and a general inability to move the affected area. Treatment of involves addressing the issues of pain and dysfunction, and managing the external or internal stressors, such as extreme climate changes or intense anxiety issues which may trigger a recurrence of the symptoms.
For mild cases of CRPS pain, over-the-counter pain medications may alleviate discomfort and decrease swelling. The application of ice can soothe inflamed areas and also aid in reducing swelling. If the area affected is cold to the touch, the application of moist heat can warm the area and decrease stiffness and pain. If the affected area is hypersensitive, topical analgesics containing lidocaine can aid in reducing these symptoms.
Physical therapy is also a way to cope with the symptoms of CRPS pain and help restore normal mobility. Modalities such as transcutaneous electrical nerve stimulation, known as TENS, can provide pain relief or help stimulate muscle contractions to aid in strengthening, depending on the settings of the unit. Physical therapy can also provide a wide range of stretching and strengthening exercises to relieve tight muscles and regain normal pain-free movement.
Biofeedback is another therapeutic option for this pain syndrome, commonly performed by a physical therapist, which helps the body discover the issues causing the pain and tightness. Once areas of unnecessary tension are uncovered, biofeedback can re-train the body into a more relaxed posture. This can alleviate pain and manage stress-related symptoms.
In extreme cases of CRPS pain, stimulation of the spinal cord may be necessary. This is a procedure where small electrodes are inserted near the spinal cord in order to decrease pain. Recurrent pain issues may require the use of anti-depressant medications to help stabilize mood and stress. These medications may also aid in relieving nerve pain common in complex regional pain syndrome.
