by Hannah Hatt

Created on: April 15, 2009

I was diagnosed with Complex Regional Pain Syndrome (CRPS) last year. My CRPS was triggered by surgery however, even minor injuries can be responsible, but the pain tends to be greater than would be expected from the type of injury sustained. This is a complex and poorly understood condition.

CRPS is a chronic pain condition that is believed to be the result of dysfunction in the central or peripheral nervous systems and occurs when the part of the sympathetic (unconscious) nervous system that controls blood flow is disturbed and becomes overactive. Burning pain, swelling, stiffness and discolouration of the affected limb(s)

Often, the exact reason for CRPS remains unknown, although is often catorgarised by type 1 or type 2. Type 1 is without nerve injury formally known as Reflex Sympathetic Dystrophy and type 2 is due to nerve injury, this was formally caused causalgia. I have type 2.

Diagnosis of CRPS is clinical and may be difficult, especially in the early stages especially within CRPS type 1 where there is no evidence of a prior injury or physical problem. Generally, the diagnostic criteria is accepted as being a history of a noxious event or immobilisation (CRPS I) or a nerve injury (CRPS II) of the affected area associated with pain that is disproportionate to the inciting event plus one or more of the following:

Abnormal function of the sympathetic nervous system

Evidence of swelling at some point in time since injury

Movement disorder

Changes in tissue growth (dystrophy and atrophy)

Absence of any condition that could cause this degree of pain or dysfunction

Patients present in complex and varied ways, the one common factor being pain. This may result in the patient being labelled as a malingerer or there may be suspicion that it is a ploy to obtain opiate analgesia. I was told I was lazy and that I couldn't be in that much pain. It was only when I sat in the doctors office crying and begging for him to amputate my leg as it was so horrendously painful that they started to listen.

The process of CRPS involves three stages.

The initial acute stage, which may last up to a few months, causes pain, often described as burning, and excess sweating in the affected part of the limb, which also becomes warm and red. During this stage, someone with CRPS may notice their hair and nails grow faster than usual. The joints of the affected limb may become painful, too.

Stage two can last up to a year and is known as the dystrophic stage. During this, the affected limb may be

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