WHAT IS PAIN?

Complex Regional Pain Syndrome

Complex Regional Pain Syndrome (CRPS) is the term used to describe pain and swelling in one part of the body. CRPS usually affects the hands, feet, elbows or knees, but can affect any part of the body.

The pain may start after an injury, where the nerves have been damaged, or there may be no known cause for the pain to start. The pain usually gets gradually worse and may spread to other parts of the body. The cause of CRPS is unknown. The disorder is unique in that it simultaneously affects the nerves, skin, muscles, blood vessels, and bones.

CRPS is quite rare, (an estimated 11,500 people in the UK have it), and half of the people that develop it, recover within a few months.

There are two types of CRPS. Type 1 – has no known cause. It used to be called Reflex Sympathetic Dystrophy (RSD), Sudecks Atrophy or Algodystrophy. Type 2 – always follows an injury and used to be called Causalgia. The signs and symptoms of both types are similar and the treatment options the same.

It is a long term condition associated with severe burning pain, excessive sweating and extreme sensitivity to touch. Patients are reluctant to move or use the affected limb due to the severe pain. The pain that patients report is out of proportion to the severity of the injury and gets worse, rather than better, over time. There are changes in bone and skin, with tissue swelling. A visible sign of CRPS near the site of injury is warm, shiny red skin that later becomes cool and bluish. These signs and symptoms may vary in severity and duration between different patients. Eventually, without movement, the joints can become stiff from disuse. Because of this, the main focus of any pain interventions is to reduce the pain to enable the patient to continue with intensive physiotherapy and movement of the affected limb.

Treatment options for CRPS include

• Painkillers
• TENS
• Stellate Ganglion Block
• Lumbar Ganglion Block
• Guanethidine Block