Complex Regional Pain Syndrome (Reflex Sympathetic Dystrophy Syndrome, Causalgia)

What is Complex Regional Pain Syndrome?

Complex regional pain syndrome (CRPS) is a chronic pain condition.  The key symptom of CRPS is continuous, intense pain out of proportion to the severity of the injury, which gets worse rather than better over time. CRPS most often affects one of the arms, legs, hands, or feet.  Often the pain spreads to include the entire arm or leg.  Typical features include dramatic changes in the colour and temperature of the skin over the affected limb or body part, accompanied by intense burning pain, skin sensitivity, sweating, and swelling.  Doctors aren’t sure what causes CRPS.  In some cases the sympathetic nervous system plays an important role in sustaining the pain.  Another theory is that CRPS is caused by a triggering of the immune response, which leads to the characteristic inflammatory symptoms of redness, warmth, and swelling in the affected area.

Is there any treatment?

Because there is no cure for CRPS, treatment is aimed at relieving painful symptoms.  Doctors may prescribe topical analgesics, antidepressants, corticosteroids, and opioids to relieve pain.  However, no single drug or combination of drugs has produced consistent long-lasting improvement in symptoms.  Other treatments may include physical therapy, sympathetic nerve block, spinal cord stimulation, and intrathecal drug pumps to deliver opioids and local anaesthetic agents via the spinal cord.

What is the prognosis?

The prognosis for CRPS varies from person to person. Spontaneous remission from symptoms occurs in certain individuals.  Others can have unremitting pain and crippling, irreversible changes in spite of treatment.