Complex regional pain syndrome (CRPS), formerly known as reflex sympathetic dystrophy (RSD), is a chronic neurological disorder that typically affects one limb (arm or leg), but can spread to other body parts, especially if left untreated.
CRPS is characterized by severe, persistent pain, swelling, stiffness, and changes in skin temperature and color. The exact cause of CRPS is not fully understood, but it is thought to be a result of impaired functioning of the small peripheral C-fiber nerve fibers – which are responsible for sending signals of pain to the brain – often after an injury or physical trauma.
Causes of CRPS
Injury or Surgery
One of the most common triggers for CRPS is an injury or surgery. This could include anything from a fracture or sprain to a surgical procedure, such as joint replacement or tendon repair. The injury or surgery may cause damage to the nerves or blood vessels in the affected limb, which can result in the development of CRPS. It is important to note, however, that not everyone who experiences an injury or surgery will develop CRPS.
Immune System Dysfunction
Another possible cause of CRPS is immune system dysfunction. Some studies suggest that the condition may be triggered by an abnormal immune response, or autoimmune response, where the body’s immune system attacks healthy tissues, leading to inflammation and pain.
Although there is no clear link between genetics and the development of CRPS, some research suggests that certain genetic variations may increase a person’s risk. The genes implicated are mainly those that influence inflammation and the immune system. More research is needed to expound the connection between genetics and CRPS.
Nerve damage is another possible cause of CRPS. If the nerves in the affected limb are damaged or compressed, they may send abnormal signals to the brain, which can result in ongoing pain and other symptoms associated with CRPS. Nerve damage can occur as a result of an injury, surgery, physical trauma, nerve entrapment, or other factors, such as diabetes or a neurological condition.
Blood Vessel Dysfunction
Blood vessel dysfunction is another possible cause of CRPS. If the blood vessels in the affected limb are damaged or constricted, they may not be able to deliver enough oxygen and nutrients to the tissues, which can lead to inflammation and pain. Blood vessel dysfunction can be caused by a variety of factors, including injury, surgery, or other underlying health conditions.
Diagnosis and Treatment
CRPS can be challenging to diagnose and treat, partly because the causes are not fully understood. A diagnosis typically involves a physical exam and medical history, as well as imaging tests and nerve conduction studies. Treatment usually involves a combination of medication, physical therapy, self-care, and psychological support.
Pain medication is often the first line of treatment for CRPS. Over-the-counter pain relievers may be sufficient for mild cases, but more severe cases may require prescription medication, such as opioids, anticonvulsants, or antidepressants.
Physical therapy can help relieve the pain and stiffness associated with CRPS, promote blood flow, and help maintain flexibility, function, and strength. Physical therapy may involve exercises to improve range of motion and strength, as well as manual therapy and heat or cold therapy. Occupational therapy may also be helpful for people who have difficulty performing daily activities due to CRPS.
Self-care can also go a long way in managing symptoms of CRPS. It involves proper stress management, relaxation techniques, sleep hygiene, healthy eating habits, and avoiding activities that trigger pain or make symptoms worse.
Your doctor may also recommend psychological support, such as therapy or counseling, to help manage the emotional and psychological aspects of living with chronic pain and improve quality of life.
The Bottom Line
CRPS is a complex, progressive, and potentially crippling neurological disorder with many potential causes. Treatment typically involves a combination of medication, physical therapy, self-care, and psychological support.
If you suspect you may have CRPS, it is advisable to seek professional help as soon as possible. Early diagnosis and treatment can help reduce pain, maintain function, and improve quality of life.