Complex Regional Pain Syndrome (CRPS)- Reflex Sympathetic Dystrophy (RSD)

Introduction

Complex regional pain syndrome (CRPS) is a type of chronic pain syndrome. CRPS was formerly called reflex sympathetic dystrophy (RSD) and shoulder-hand syndrome. CRPS causes severe burning pain and possible eventual deterioration of an affected arm or leg. The cause of CRPS is unknown, but it can develop following an injury, stroke, or heart attack. Prompt treatment is associated with the best outcomes. If untreated, CPRS can cause irreversible extremity deterioration.

Anatomy

The sympathetic nervous system is a part of the complex system that regulates involuntary bodily functions. These are bodily functions that run automatically and are necessary for life. Your sympathetic nervous system speeds up your heart rate, constricts your blood vessels, sends blood to your vital organs, raises your blood pressure, raises your blood sugar level, and increases sweating. It energizes your body for immediate action in response to an emergency or “flight or fight” situation.

Causes

The exact cause of CRPS is unknown. Researchers suspect that changes in the sympathetic nervous system lead to poor regulation of blood flow, sensation, and temperature. This contributes to problems involving the skin, nerves, blood vessels, bones, and muscles. Another theory is that it may be related to an immune response. CRPS can develop after an injury or infection in the arm or leg. It can occur after heart attacks, cancer, nerve compression, and strokes.

Symptoms

The symptoms of CRPS vary from person to person. Severe burning pain, joint stiffness, and swelling are hallmark symptoms of CRPS. It can affect an arm or leg. CRPS is characterized by three stages. Not all people progress through all three of the stages. Some people may stay in the first stage indefinitely, and others may skip a stage.

Diagnosis

Early diagnosis of CRPS is important for the best treatment results. Your doctor can diagnose CRPS by reviewing your medical history and conducting a physical examination. You should tell your doctor about your symptoms and their progression. Your doctor will examine your limb for skin changes, swelling, changes in blood flow, and loss of mobility. Your doctor may order tests such as X-rays, bone scans, or nerve studies. There is no test, however, that can diagnose specifically CRPS.

Treatment

To ensure the best outcome, it is important to start treatment as soon as possible. CRPS is treated with medications, therapy, injections and surgery. There is no true cure for CRPS, but treatments in the early stages can prevent the disease from progressing, and cause symptoms to regress. Treatment goals during the advanced stages are aimed at symptom relief and improving function.
Your doctor can prescribe medications to help ease your symptoms. A combination of medications may be used.
Physical Therapy is very Important.
US Guided Nerve Block or Sympathetic Block, Followed by Physical Therapy.
Early and Aggressive treatment is recommended.
Early trial of Spinal Cord Stimulator.

Prevention

There is no known prevention for CRPS. Prompt treatment may prevent the progression of symptoms.