Lingering pain after a traumatic event or injury is generally regarded as uncommon and serious. One such form is a condition known as complex regional pain syndrome (CRPS). This condition is most frequently found in individuals who have sustained an injury, had surgery, a stroke, or heart attack but it affects a certain limb in a way that is uncharacteristic of the injury or surgery itself. When it does occur it is most commonly experienced in middle age and affects women more than men.
Even though it is frequently associated by trauma or injury the exact cause of this condition is not clear. Complex regional pain syndrome is not consistent and not every patient who suffers from the same injury will develop the condition. In spite of being rare, patients are encouraged to understand the early signs and symptoms so treatment can begin as quickly as possible.
Causes of complex regional pain syndrome
There are two primary forms of complex regional pain syndrome, which have the same symptoms but are believed to have different causes.
Type 1, or reflex sympathetic dystrophy syndrome, is complex regional pain syndrome that is experienced after the patient has an injury or illness that did not directly affect the nerves. This is the most common type of the condition. Type 2, or causalgia, occurs after a distinct nerve injury.
Most cases happen after a traumatic injury, usually to an arm or a leg. This occurs with crushing injuries, fractures, or amputations. Surgeries and infections can also lead to the condition. In some cases even a sprained ankle or emotional stress may bring it on. Since these causes are so disparate it is difficult to completely understand why they trigger complex regional pain syndrome. It is currently believed that it may be due to a dysfunctional communication between the central and peripheral nervous systems that causes inappropriate inflammation.
Early diagnosis and treatment is critical when it comes to complex regional pain syndrome. The two most common complications that result from the condition are atrophy and muscle tightening. When it is painful to move because of the irritation and inflammation in the nerves, many patients will avoid motion all together. This eventually leads to the weakening of the bones and muscles in this area of the body. With muscle tightening, the limb becomes contracted in a fixed positon. Both of these complications are difficult to reverse.
Signs and symptoms
Due to the rarity and complex nature of this condition, it is extremely important that at-risk individuals watch out for these signs and symptoms. These include:
- Continuous throbbing or burning pain in a limb
- Sensitivity to cold or touch
- Swelling in the area experiencing pain
- Extreme and unexplained changes in the temperature of affected body part
- Changes in skin color of affected body part such as skin that becomes white or mottled blue and red
- Skin texture changes such as tenderness and thinning
- Changes in hair and nail growth
- Stiffness, swelling, and damage of the joints
- Weakness or loss of muscle
- Muscle spasms
- Inability to move affected area
If you have experienced a traumatic injury and notice one or more of these symptoms it is important that you talk to your doctor to find out if you might be affected by complex regional pain syndrome.
It is possible to effectively treat complex regional pain syndrome and even send the condition into remission. Most patients see the best results with a combination of treatment and therapy options.
Multiple medications have been used to treat and reduce the symptoms of complex regional pain syndrome. They include:
- Over-the-counter pain relievers
- Antidepressant medications
- Bone-loss medications
- Sympathetic nerve-blocking medication
- Intravenous ketamine
In some cases, patients can be prescribed higher doses or opioid medications to control the symptoms, however these treatments are typically considered a last resort after all other methods of control fail. They must be taken with caution and under the care of your physician.
Other therapies that are helpful for complex regional pain syndrome include:
- Application of heat and ice to the affected area
- Topical creams to reduce sensitivity, such as capsaicin or lidocaine
- Physical therapy
When recurrences of the condition do occur there are usually responsible triggers such as extreme cold or intense emotional stress. If you’ve been diagnosed with complex regional pain syndrome and have been treated effectively it is critical to watch for and avoid triggers in your life wherever possible.
There are ways to prevent the occurrence of complex regional pain syndrome after a traumatic injury. Studies have demonstrated that people who take additional vitamin C after a fracture of the wrist have a lower risk of developing complex regional pain syndrome than those who do not. Adding this additional supplement after an injury can cause no additional harm in most cases so it is worth the extra effort.
In the cases of complex regional pain syndrome brought on by a stroke, it has also been shown that individuals who move as early as possible after the incident have a lower risk of the condition as well.
Because living with a chronic pain condition, especially one that is unpredictable and unexplainable, can be difficult there are a variety of things we recommend to ensure that you can have as normal a life as possible. CRPS is a hidden condition and since no one else can understand the severity of the pain you are experiencing it can be frustrating, to say the least. If you are dealing with the effects of complex regional pain syndrome we highly recommend seeking out a support group either in your community or online to have an outlet to discuss the shared experience of the condition.
To help maintain your emotional and mental health we also encourage you to continue with as many normal daily activities as possible to maintain a sense of normalcy in your life. Recognize the value of rest and don’t push yourself too hard physically. Stay connected with friends and family. Find joy in your hobbies. Don’t be afraid to seek professional help to cope with the emotional side effects of this condition. Self-care is often the most important piece of the puzzle when it comes to living with the effects of complex regional pain syndrome.
Do you have any experience with complex regional pain syndrome?
Image by Kayla Kandzorra via Flickr