Complex regional pain syndrome

What is complex regional pain syndrome?

Complex regional pain syndrome (CRPS) is the experience of persistent and severe, long-lasting, and debilitating pain, often after an injury to bone or soft tissue. In many cases of the disease, pain slowly fades over time, and may disappear completely. However, in some cases the symptoms of CRPS may persist for years. Middle aged woman seem to be more susceptible to the condition.

What are the symptoms of CRPS?

CRPS primarily presents as continuous and severe burning, stabbing, or stinging pain in the arms, legs, hands, or feet. Although the condition begins at the site of injury, the symptoms often spread to the rest of the limb, usually on one side of the body. Pain may, however, begin to affect other regions of the body as the disease progresses. Additional common symptoms include tingling and numbness of the affected areas, as well as increased sensitivity to pain in the surrounding skin (hyperalgesia). Sensitivity may increase to such an extent that normally painless stimuli (such as soft touch or slight change in temperature) trigger extreme discomfort (allodynia). Episodes of increased pain may be experienced intermittently, known as “flare-ups”, and may last days or weeks.

A number of other symptoms besides chronic pain may also occur, including:

  • Swelling and stiffness of affected areas and joints
  • Muscle spasms and tremors
  • Osteoporosis in the affected limb
  • The feeling that the affected area is not part of one’s body, is out of proportion, or other extraordinary sensations
  • Skin may be at times hot, red, and dry, and at others, cold, blue, and sweaty.
  • Unusual rapid or slow growth and fragility of hair and nails, and nails may become grooved

What further complications are associated with CRPS?

Severe chronic pain in this form can result in a significant reduction in quality of life. One’s ability to move, travel, think clearly, and sleep is retarded, leading to both physiological and psychological problems such as anxiety and depression, and even suicide.

A number of other complications may also result, but are rare. These include open sores and skin infections, shortening and reduced movability of muscles (muscle contractures), and the wasting away of muscles (muscle atrophy)

How is CRPS treated?

  • Step 1 – the alleviation of acute pain to improve your quality of life and help you to remain functional and productive.
  • Step 2 – the implementation of preventative self-help strategies to control your level of pain, maintain mobility, and reduce chronic inflammation.

Acute pain management

  • Anti-inflammatory drugs (NSAID’s) – these are good options to assist with acute pain. However, they should all be used with caution over the long term, since as a class, these drugs pose a significant side-effect risk relating to cardio-vascular, gastro-intestinal and kidney disease. (Ask your doctor or pharmacist for advice).
  • Analgesics – paracetamol (acetaminophen) and opiates or opiate derivatives are often required to help alleviate acute pain. These drugs serve as symptomatic relief, lowering the sensation of pain, but do not combat the underlying cause. Opiates may cause drowsiness, constipation and addiction. (Ask your doctor or pharmacist for advice).
  • Hot or cold packs – applying a heat pack to your neck can help to ease pain. You can use a microwavable heat pad or hot-water bottle. Heat alters the sensation of pain. Cold (for example a bag of frozen peas) may reduce inflammation by decreasing the size of blood vessels and the flow of blood to the area, and may reduce the sensation of pain through reducing nerve activity
  • Rehabilitation therapies – Physiotherapy, biokinetics, or chiropractic therapy will prove helpful.

Preventative self-help strategies:

  • Exercise
    Research has shown that regular exercise provides numerous benefits for those suffering from CRPS. Exercise can decrease pain, increase flexibility, strengthen the heart and improve blood flow, help maintain weight, promote general physical fitness and improve mood. Contracting muscles also release multiple substances, known as myokines, which promote the growth of new tissue and facilitate tissue repair. Myokines have multiple anti-inflammatory effects, which in turn reduce your overall risk of developing various inflammatory diseases.
  • Use supplements that combat inflammation
    Various natural molecules derived from plants are highly effective in suppressing pathways involved in chronic inflammation. These generally have a low side-effect risk, making them an attractive approach when compared to other pharmaceuticals. RheumaLin™ is a novel multi-modal, multi-target anti-inflammatory supplement that consists of two plant extracts, Boswellia bark extract and resveratrol. These naturally derived phytochemical (plant based) compounds are widely recognised. They combat inflammation via biochemical mechanisms that are different to those of existing anti-inflammatory drugs. A large number of high-level research projects have produced strong evidence that these agents alleviate inflammation. Read more about RheumaLin