CRPS I & CRPS II.

There are 2 kinds of Complex Regional Pain Syndrome. CRPS Type I and CRPS Type II.

CRPS type one can happen for any reason. Some people experience a trauma to the area, for example a sprain, whereas other people may simply wake up one morning with the excruciating pain. Type two will always happen after a trauma and there is always another kind of nerve damage as well as the CRPS. eg, a severed nerve. CRPS is a form of nerve damage, but CRPS type two also has another kind of nerve damage alongside it.



Does it have any other names?

Over the years, the condition has been called many different names. Some of these include;

Algodystrophy,
Sudeck's Atrophy,
Causalgia,
Algoneurodystrophypost-traumatic dystrophy,
shoulder-hand syndrome,
reflex neurovascular dystrophy,
Sudeck's osteodystrophy,
Traumatic vasospasm,
Variable pain syndrome.

All of these conditions are exactly the same thing.


RSD/CRPS has been documented since the American Civil War, however even today little is known about the condition.





Who Can Get RSD/CRPS?

Anyone can get RSD/CRPS. Statistics show that women in their 40s are slightly more likely to get the condition. Children can get RSD/CRPS, as can teenagers and both men and women of any age group. RSD/CRPS is most commonly developed after an injury of some kind, though for some people no injury occurs, RSD/CRPS just appears. No one knows why some people will get RSD/CRPS after an injury and other people won't, or what makes the RSD/CRPS develop because of that specific injury.

Signs and Symptoms

Some of the physical signs of CRPS can be swelling, colour changes of the affected area, sweating, hypersensitivity, rashes, bone changes, nail changes, hair changes, lack of movement of the area, dystonia, involuntary movements and temperature changes. Swelling can vary from being slightly swollen to extremely swollen. Colour changes can cause the area to look mottled, red, blue, purple etc. Nails may develop more ridges, become ridged and grow slower than nails on an unaffected limb. Hair may grow patchy, change colour to what it once was and become more coarse, this includes hair on the patients head as well as the affected area. The area may feel burning hot to the patient but be very cold to touch.
Some of the symptoms of CRPS can be chronic pain (almost always present), peculiar sensations (for example extreme pins and needles or running water on the area), burning, shooting, stabbing, aching weakness, depression caused by drastic changes and pain, lack of control over the area and not knowing where the area (for example limb) physically is.
RSD/CRPS can often have a "knock on effect" on the rest of the body, causing further problems, due to the malfunction of the sympathetic nervous system. These include allergies/asthma, absence or abnormal menstrual cycle, chest pain, cardiac complications, chronic fatigue, autoimmune disorders such as arthritis and Crohn's disease, IBS (digestive problems-acid reflux, constipation ), fibromyalgia/myofacial syndrome, hypertension, Raynauds disease, increased sensitivity to external stimuli ( sight, sound, smell), insomnia, memory loss, migraine headaches, mood swings/anxiety, tremors and visual disturbances. Existing conditions can also worsen, for example asthma can worsen and become harder to control.
Depression can also occur as a result of RSD/CRPS, the pain and other symptoms inevitably have an impact on patients lives, for example insomnia, feeling isolated and that no one understands, changes in lifestyle, mobility problems and so forth.


Diagnosis

It can be extremely hard to diagnose RSD/CRPS. There is no one test that will confirm that a patient has the condition. To get to a diagnosis of RSD it is more likely that other causes of the symptoms will be ruled out first before a diagnosis of RSD/CRPS is made.

Prognosis and Treatment

Around 50% of patients with RSD/CRPS will get better and fully recover from the condition. Of the other patients, many will go on to lead near to normal lives. Recovery chances are at their best when treatment starts within 3 - 6 months of the patient initially getting RSD/CRPS. Some of these treatments may include regular but not aggressive physiotherapy (the key is 'little and often'), analgesia, anticonvulsant medications, antidepressant medications, nerve blocks, TENS machines, mirror therapy, Hyperbaric Oxygen Therapy (HBOT) and Spinal Cord Stimulators. It is important to keep the area moving regularly'.



Ice should be avoided. Ice will make the condition worse, causing freeze damage to nerves, increasing the pain due to the damage caused to the nerves and causing sensory loss.



Some drugs commonly used in the treatment of CRPS include codine based painkillers, tramadol, morphine, gabapentin and other anticonvulsants, amatryptaline and other tricyclics, diclofenac and pregabalin.



Some people will get better, other people won't. Some people get better with the help of medical treatment whereas other people will get better without medical treatment. Unfortunately there is no way for doctors to tell who will get better and who won't or why some treatments considerably help some patients and have little or no effect on other patients.



Medical professionals that a patient may see in their treatment are their general practitioner (GP), consultants such as rheumatologists, neurologists and pain clinician, pyshiatrist or counsellor (to help come to terms with having RSD/CRPS), a physiotherapist, occupational therapist and social worker.




Some patients find alternative therapies help control their pain, these may include distraction techniques, relaxation techniques, reiki, acupuncture and similar therapies. Some patients have reported that orgasm significantly reduces their pain for a short time, the theory behind this is the brain can only cope with one major sensation at a time and since the pain is continuous, orgasm is 'a new sensation' in comparison, so the brain focuses on the sensations of the orgasm instead of the pain.

Can RSD/CRPS spread?

Technically it already has spread, as fit the criteria for RSD/CRPS the signs and symptoms must have spread from the original area of injury, eg if the injured area was the tip of a thumb it may have spread to the entirety of the thumb, hand or even up the arm.

RSD/CRPS can spread to other areas of the body, both for no reason or after a trauma to another part of the body.


If an operation is to take place on another part of the body, some doctors and patients have found that a spread of the RSD/CRPS to that unaffected area is far less likely if a nerve block has been preformed prior to the operation.


Having bloods taken causes, in effect, an injury to the site where the needle was inserted. In most cases, this won't be any more problematic for the patient than any other patient (so long as blood isn't being taken from a site where RSD/CRPS is present), however in some cases, having blood taken has caused RSD/CRPS for some patients. Some doctors advise that numbing cream and a finer needle can help reduce the risks of this, the numbing cream working in a sense that the nerves aren't sending messages to the brain saying that the area is injured.

It is important to remember that not all pain in other areas will be a spread or RSD/CRPS and if you suspect a spread, you should seek medical advice. Just because it is possible for the condition to spread, doesn't mean that the condition will inevitably spread for every patient.

Pregnancy and RSD/CRPS

For some women with RSD/CRPS during pregnancy, their RSD/CRPS may become more tolerable, for others it may become less tolerable or stay the same. Women with RSD/CRPS who are wishing to become pregnant should discuss this with their doctor, especially as some medications used in the treatment of RSD/CRPS are not advised during pregnancy.

Disclaimer
Please note that Fighting RSD accepts no responsibility for the accuracy of the content on this website or the associated support forum. The opinions put forward on this site is that of patients with the condition, who have no medical training.