Complex Regional Pain Syndrome (CRPS), also known a Reflex Sympathetic Dystrophy (RSD), is a complicated medical condition which frequently is not diagnosed and treated properly. This article is intended to provide basic information as to what CRPS is, and what some of the treatment options are.
WHAT IS CRPS?
CRPS is a chronic neurological syndrome characterized by:
- Severe burning pain
- Bone and skin changes
- Extreme sensitivity to touch
Usually, CRPS starts with trauma to an extremity. For example, the patient may sustain a fall injury directly on the foot, or crush injury to the hand. Pain continues and is far greater than anticipated given the traumatic event. A telltale characteristic of CRPS is extreme sensitivity to the slightest touch. Other evidence of CRPS can be swelling, redness, skin color and skin temperature changes.
There is no single laboratory test to diagnose CRPS. The diagnosis should be considered by a qualified medical doctor when a work injury does not heal as expected. Assessment should be made to determine whether major nerve injury occurred. However, CRPS may exist when there is no nerve injury immediately identified.
Early diagnosis is key to effective treatment. CRPS needs to be evaluated by a neurologist, anesthesiologist, rheumatologist, or physical medicine and rehab doctor. It is important that you provide the doctor with all of your medical records so that they can document medical history, subjective complaints and objective findings on physical examination. A regional nerve block which temporarily eliminates pain may suggest the possibility of CRPS. Several conditions need to be considered and ruled out by medical professionals as other possible causes for continued symptoms.
When CRPS is diagnosed, proper treatment requires a team approach. A doctor who has extensive knowledge treating CRPS should coordinate medical intervention. Treatment may include nerve blocks, medications and physical therapy to reduce pain and increase functional abilities. Consideration may be given to implanting a device in the spinal cord if more conservative measures fail. Electrical signals are sent through the implanted device to block pain.
Patients with CRPS commonly suffer from depression and anxiety. Therefore, it is helpful to include psychological counseling in the treatment plan. Psychological counseling can be crucial for patients who are experiencing the frustration of persistent symptoms despite extensive medical treatment. Counseling may also be beneficial in helping patients cope with decreased self-esteem they experience with job loss and inability to function effectively.
In summary, CRPS is a poorly understood, complicated medical diagnosis. CRPS should be adequately evaluated by qualified medical practitioners in instances where CRPS symptoms are present and pain persists without explanation.