Learn about this neurological condition that may affect an arm or a leg after an injury or surgery. Early treatment may prevent a recurrence.
Complex regional pain syndrome (CRPS) is a form of chronic pain that usually affects an arm or a leg. CRPS typically develops after an injury, a surgery, a stroke or a heart attack. The pain is out of proportion to the severity of the initial injury.
CRPS is uncommon, and its cause isn't clearly understood. Treatment is most effective when started early. In such cases, improvement and even remission are possible.
Signs and symptoms of CRPS include:
Symptoms may change over time and vary from person to person. Pain, swelling, redness, noticeable changes in temperature and hypersensitivity (particularly to cold and touch) usually occur first.
Over time, the affected limb can become cold and pale. It may undergo skin and nail changes as well as muscle spasms and tightening. Once these changes occur, the condition is often irreversible.
CRPS occasionally may spread from its source to elsewhere in the body, such as the opposite limb.
In some people, signs and symptoms of CRPS go away on their own. In others, signs and symptoms may persist for months to years. Treatment is likely to be most effective when started early in the course of the illness.
If you experience constant, severe pain that affects a limb and makes touching or moving that limb seem intolerable, see your health care provider to determine the cause. It's important to treat CRPS early.
The cause of CRPS isn't completely understood. It's thought to be caused by an injury to or difference in the peripheral and central nervous systems. CRPS typically occurs as a result of a trauma or an injury.
CRPS occurs in two types, with similar signs and symptoms, but different causes:
Many cases of CRPS occur after a forceful trauma to an arm or a leg. This can include a crushing injury or a fracture.
Other major and minor traumas — such as surgery, heart attacks, infections and even sprained ankles — also can lead to CRPS.
It's not well understood why these injuries can trigger CRPS. Not everyone who has such an injury will go on to develop CRPS. It might be due to an interaction between your central and peripheral nervous systems that isn't typical and different inflammatory responses.
If CRPS isn't diagnosed and treated early, the disease may progress to more-disabling signs and symptoms.
These steps might help you reduce the risk of developing CRPS:
Diagnosis of CRPS is based on a physical exam and your medical history. There's no single test that can definitively diagnose CRPS, but the following procedures may provide important clues:
There's some evidence that early treatment might help improve symptoms of CRPS. Often, a combination of different treatments, tailored to your specific case, is necessary. Treatment options include:
Doctors use various medications to treat the symptoms of CRPS.
Pain relievers. Pain relievers available without a prescription — such as aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) — may ease mild pain and inflammation.
Your doctor may prescribe stronger pain relievers if OTC ones aren't helpful. Opioid medications might be an option. Taken in low doses, they might help control pain.
It's possible for CRPS to recur, sometimes due to a trigger such as exposure to cold or intense emotional stress. Recurrences may be treated with small doses of an antidepressant or other medication.
Living with a chronic, painful condition can be challenging, especially when — as is often the case with CRPS — your friends and family don't believe you could be feeling as much pain as you describe. Share information from reliable sources about CRPS with those close to you to help them understand what you're experiencing.
Follow these suggestions to take care of your physical and mental health:
If CRPS makes it difficult for you to do things you enjoy, ask your provider about ways to get around the obstacles.
Keep in mind that your physical health can directly affect your mental health. Denial, anger and frustration are common with chronic illnesses.
At times, you may need more tools to deal with your emotions. A therapist, behavioral psychologist or other professional may be able to help you put things in perspective. He or she may also be able to teach you coping skills, such as relaxation or meditation techniques.
Sometimes joining a support group, where you can share experiences and feelings with other people, is a good approach. Ask your provider what support groups are available in your community.
To get the best medical care, take time to prepare for your appointment.
Write down any symptoms you're experiencing — including the severity and location of your pain, stiffness or sensitivity. It's also a good idea to write down any questions you have for your provider.
Examples of questions you might ask your provider include:
In addition to the questions that you've prepared to ask your provider, don't hesitate to ask additional questions during your appointment.
Your provider is likely to ask you a number of questions. Being ready to answer them may leave time to go over any points you want to spend more time on. For CRPS, your provider may ask: