Complex Regional Pain Syndrome (Reflex Sympathetic Dystrophy)
Complex Regional Pain Syndrome (Reflex Sympathetic Dystrophy)
Complex regional pain syndrome (CRPS) is a condition of intense burning pain, stiffness, swelling, and discoloration that most often affects the hand. Arms, legs, and feet can also be affected by CRPS.
This condition was previously known as reflex sympathetic dystrophy, Sudeck's atrophy, shoulder-hand syndrome, or causalgia.
Description
There are two types of CRPS:
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Type 1 occurs after an illness or injury that did not directly damage a nerve in the affected area
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Type 2 follows a distinct nerve injury
Although the triggers vary, both types of CRPS have the same symptoms and go through the same three stages of disease.
Stage I: Acute
Stage I may last up to 3 months. Burning pain and increased sensitivity to touch are the most common early symptom of CRPS. This pain is different — more constant and longer lasting — than would be expected with a given injury. Swelling and joint stiffness usually follow, along with increased warmth and redness in the affected limb. There may be faster-than-normal nail and hair growth and excessive sweating.
Acute stage CRPS. This photo was taken 2 months after the injury
Stage II: Dystrophic
Stage II can last 3 to 12 months. Swelling is more constant and skin wrinkles disappear. Skin temperature becomes cooler. Fingernails become brittle. Pain is more widespread, stiffness increases, and the affected area becomes more sensitive to touch.
Stage III: Atrophic
Stage III occurs after 1 year. The skin of the affected area becomes pale, dry, tightly stretched, and shiny. The area is stiff and there is less hope of getting motion back. Pain may decrease and the condition may spread to other areas of the body.
Cause
Although the two types of CRPS can be tied to injury or illness, the exact cause of CRPS is unknown. One theory is that a "short circuit" in the nervous system is responsible. This "short circuit" causes overactivity of the sympathetic (unconscious) nervous system which affects blood flow and sweat glands in the affected area.
Symptoms most commonly occur after injury or surgery. Other causes include pressure on a nerve, infection, cancer, neck problems, stroke, or heart attack.