by A Morris

Created on: February 20, 2009

Complex Regional Pain Syndrome (CRPS) is a chronic condition relating to the nerves. More importantly, it relates to the sympathetic nervous system, which controls sweating, circulation, pain response, hair growth, inflammation and other responses. Also known as Reflex Sympathetic Dystrophy (RSD), this condition is often hard to diagnose and is misunderstood. Because the condition is rare, many doctors are not familiar with the symptoms and may find it hard to diagnose the problem. CRPS shares symptoms with other conditions, and often only one or two sympstoms may present at any one time.

The condition is split into two types. Type I follows a soft tissue injury, broken bone or fracture, and often occurs when the affected limb has been immobilised with a splint or cast. Type II follows partial nerve damage from a more serious injury like a gunshot wound or crushing injury. With both types, there is excessive pain beyond that of the original injury, and levels of pain and symptoms increase with time. While a patient may present only one or two symptoms in the early stages, they may develop further symptoms later on. In very rare case, the pain may even spread to the opposite limb. This is often referred to as a mirror image symptom.

Experience tells us that early diagnosis and treatment are paramount to prevent the development of the condition. Those patients who experience Type I CRPS may develop Type II if the condition worsens. Over prolonged lengths of time, the patient may suffer irreversible changes to the skin and bones, causing bone weakness and muscle atrophy. The key is to begin treatment as soon as possible, and to get the patient moving the affected limb and using it normally.

Symptoms of CRPS include burning, tingling, changes in temperature (often the affected limb may be several degrees hotter or colder than the other), abnormal changes in skin colour (allodynia), increased sensitivity to pain (a breath of wind can feel like the stab of a hot knife). Some patients experience tremors in the affected muscles, changes in hair and nail growth and abnormal sweating. Patients may also develop an actalgic gait, where they change the way they move to counteract further pain.

Treatment of this condition is often slow and painful. Ideally, doctors will aim to get the patient moving and load-bearing as soon as possible, as immobilisation may make the condition worse. This is achieved through physical therapy and desensitization. The latter process involves softly

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