& CRPS II.
There are 2
kinds of Complex Regional Pain Syndrome. CRPS Type I and CRPS Type
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.
Over the years,
the condition has been called many different names. Some of these
reflex neurovascular dystrophy,
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.
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.
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.
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
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.
commonly used in the treatment of CRPS include codine based
painkillers, tramadol, morphine, gabapentin and other
anticonvulsants, amatryptaline and other tricyclics, diclofenac and
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.
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.
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.
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.
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
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
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.
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.