Complex Regional Pain Syndrome is indeed complex and painful

Sakkas Cahn & Weiss

Injuries to the hands or feet sometimes lead to ongoing symptoms long after the underlying injury. The person may experience burning pain, swelling or discoloration in the extremity. The affected area may become extremely sensitive to touch or any movement.

The medical term is complex regional pain syndrome, or CRPS. It is also known as reflex sympathetic dystrophy (RSD) or causalgia. CRPS is a real medical condition. The pain can be disabling. Early diagnosis and treatment is important to alleviating the symptoms and reducing the duration.

Symptoms of complex regional pain syndrome (CRPS)

Complex regional pain syndrome is a condition characterized by various symptoms following a triggering event. The event could be an accident or surgery, especially involving damage to the peripheral nerves. CRPS/RSD is also associated with heart disease and stroke, carpal tunnel syndrome, degenerative arthritis, shingles, breast cancer and certain medications.

The mechanism of complex regional pain syndrome (reflex sympathetic dystrophy) is not well understood, but it is believed to be tied to irritation or over-stimulus of nerve tissues in blood vessels and the skin. The range of symptoms includes burning sensation, flushing or blanching, local swelling, and pain or tenderness in the affected region. As it progresses, CRPS can cause serious and painful changes to surrounding tissues, including bone.

Three distinct stages of CRPS (RSD)

  • The acute stage typically lasts three to six months. The symptoms are most severe during this period. Common symptoms are swelling, stiffness, burning pain, hot or cold skin, and sweating in the vicinity of the wound.
  • The dystrophic stage can last another three to six month. Typically there is less flushing or swelling, but the skin may change in appearance (shiny or discolored) and patients may struggle with persistent pain.
  • The atrophic stage can last for months or years, or end abruptly. Some patients experience a loss of motion or loss of function in the affected area, or tremors or spasms. The fatty layers under the skin may thin, and loss of bone mass (osteoporosis) may occur.

Diagnosis and treatment of complex regional pain syndrome

Diagnosing CRPS/RSD is tricky because the symptoms vary widely from one person to the next. Diagnostics may include X-rays and other radiology, sweat testing, or electrodiagnostic nerve testing, in conjunction with clinical examination by a physician.

Depending on the stage and severity of symptoms, treatment may include cold compresses, exercise/physical therapy, anti-inflammatory medications, pain medications (other than opioids), injected nerve blocks, or surgical treatments to disrupt the nerves or insert pain medication pumps. The goal is to reduce the pain and minimize loss of functionality in the affected limbs or skin.

If complex regional pain syndrome develops in the aftermath of a work accident or personal injury such as a car accident, there may be legal remedies to help with the extensive medical bills, lost time from work, and ongoing disabilities, pain and suffering. Talk to a lawyer who is familiar with the legal and medical issues with a diagnosis of CRPS/RSD.

Source: MayoClinic.org, MedicineNet.com

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