You may be asking, “What is CRPS?” CRPS is a chronic condition that causes constant, burning like or fire-like pain, usually in an arm or leg. Patients are often sensitive even to light touch. CRPS typically manifests after an injury such as a fracture or even something as innocent as an object dropping on your foot. However, the severity of pain is usually worse than the original injury itself. Doctors don’t know exactly what causes CRPS, but it is thought to be a condition where an injury causes nerve to fire inappropriately like a smoke alarm going off when there is no fire.
CRPS is classified as either Type I or Type II. Type I CRPS is a result of a direct nerve injury such as a transection or gunshot wound, whereas CRPS Type II is a result of a more indirect injury, such as twisting your ankle.
Doctors theorize that the chronic pain caused by CRPS comes from a dysfunction of the sympathetic nervous system. Your sympathetic nervous system is the branch of the nervous system associated with “fight or flight.”
When you suffer an injury, your sympathetic nervous system tells your blood vessels to get smaller so you don’t lose too much blood at the site of the injury. Then, it signals the vessels to open back up so blood can get to damaged tissue and repair it.
With CRPS, your sympathetic nervous system receives confusing signals. It reacts after an injury but then it doesn’t turn back off. This can cause severe chronic pain and swelling at the injury site. It is akin to “nerves gone wild”
Despite what information doctors have gathered, it is still possible to contract this chronic pain syndrome without having suffered an injury.
CRPS symptoms usually show up over the course a few days to a few weeks following an injury. You may have pain first and then it can worsen over time. It’s most common to experience CRPS in your arms, hands, legs, and feet. Normally the pain radiates beyond the injury site. In some cases, symptoms can spread to other parts of your body as well.
Symptoms of CRPS can include:
- Changes in skin temperature
- Sensitivity to light touch (i.e. sheets, socks)
- Hair loss on the affected limb(s)
- Color changes in the skin of the affected limb
The pain associated with this CRPS is commonly described as:
Other symptoms associated with CRPS include:
- Changes in your hair or nail growth.
- Excess sweat in some areas of your body.
- Muscle weakness or spasms.
- Stiff joints.
- White, mottled, red, or blue skin.
CRPS responds best to treatment if initiated in the first three months following the onset of symptoms. However, treatment can be successful if started later. There are numerous treatment options for CRPS. Cool compresses on the affected areas can contribute to some relief of burning symptoms. Medications are often the first-line treatment, as are special injections called sympathetic blocks.
For ongoing symptoms, powerful doses of prednisone can be used for periods of weeks, depending on the response, and then gradually reduced. Other medications that may be of benefit include amitriptyline, pregabalin, Ketamine, and clonidine.
When medication management, PT and sympathetic blocks fail to provide meaningful relief spinal cord stimulation (SCS)—a pacemaker for pain—is an important treatment option.
CRPS is a complex and painful disease of nerves that can cause severe disability. Especially when caught early an interventional pain management specialist can help to mitigate the symptoms and improve a patient’s quality of life by reducing their pain and possibly even arresting CRPS.
If you have been diagnosed, or believe you may have CRPS, consult with your physician to determine a treatment plan to alleviate your chronic pain.