Category: Complex Regional Pain Syndrome

Explore Complex Regional Pain Syndrome (CRPS), its symptoms, causes, and treatment options to manage chronic pain and improve quality of life.

  • CRPS and anxiety

    Most people have feelings of anxiety – a feeling of unease, such as worry or fear, that can be mild or severe – at some point in their life. Anxiety is an illness from which people cannot ‘snap’ out and it is thought that approximately 8 million people in the UK have some form of an anxiety disorder.

    Anxiety is not the same as stress, and it can persist whether or not there are obviously external factors. The feelings associated with anxiety can be overwhelming, stopping the individual from doing things or making them behave in an unusual way.

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    CRPS patients often experience cognitive changes, anxiety, and depression, and stress can cause a flare-up of CRPS symptoms so it is important to understand and make sense of the illness in the first place before working out how best to manage it.

    Types of CRPS

    There are two types of CRPS:

    • type 1, previously known as reflex sympathetic dystrophy or RSD, and
    • type 2, previously known as causalgia.

    The difference between these two types is whether nerve damage is involved.

    Diagnosing CRPS Type 1 is particularly difficult as there is no damage to the nerves and usually no damage to the bone and little damage to the tissue. The pain is out of proportion to the accident or injury that occurred and the main symptoms are usually allodynia, continuing pain, and hyperalgesia, disproportionate pain to touch, movement or pressure.

    CRPS Type 1 is usually diagnosed if the above symptoms are found as well as some kind of oedema, changes to the blood flow (and therefore temperature) in the affected area and other conditions have been ruled out.

    Type 2 is the rarer of the two conditions. CRPS Type 2, formerly known as causalgia, is a severely painful and chronic condition which develops as a result of an injury to a peripheral nerve. The pain associated with CRPS Type 2 is usually described as an intense burning which doesn’t subside and the pain is specific to the affected area, due to the injury to the nerve.

    CRPS Type 2 is different to Type 1 because of the tangible nerve injury which can be found and also because the pain doesn’t migrate from the original site. Whilst Type 1 may result in pain in the whole limb over time, CRPS Type 2 is a condition which remains specific to the original place that was injured.

    CRPS Type 2 is caused by a trauma to a large nerve in one of the limbs, usually in the peripheral nervous system. CRPS Type 2 can be caused by a simple injury or something more traumatic such as a car accident or a fall from a height. The disease progresses over time and can result in loss of movement and mobility in the affected limb, alongside increased pain.

    The symptoms of CRPS Type 2 are quite similar to those of CRPS Type 1 which is why a full diagnosis needs to be carried out by your doctor who may refer you to further specialists to ascertain the exact root cause of the pain. Symptoms of CRPS Type 2 include the burning pain already mentioned as well as sweating, discolouration of the skin in the affected area and hyperalgesia, extreme pain felt from disproportionate action such as light touch, pressure or movement.

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    CRPS Type 2 can also change the rate at which hair and nails grow and it’s also more common that the joints in the affected area may seize up or spasm.

    Budapest criteria

    The Budapest Criteria is often used to diagnose CRPS and differentiates between ‘signs’ and ‘symptoms’.

    Symptoms:

    • Sensory – Hyperaesthesia (an abnormal increase in sensitivity), and/or allodynia, which is pain caused by stimuli which shouldn’t trigger a painful response. Examples of allodynia include lightly touching the affected limb, perhaps by moving a bedsheet or by a gentle tap on the wrist.
    • Vasomotor – Skin colour changes and/or changes in the temperature of the limb.
    • Sudomotor/oedema – Swelling of the limb and/or an excess of sweat from the affected limb, or changes in sweating swelling of the limb.
    • Motor/Trophic – Decreased range of motion and/or motor dysfunction, including weakness, spasms, tremors or wasting. Trophic changes include changes to the hair, nails or skin on the affected limb.

    Signs:

    • Sensory: Hyperalgesia (to pinprick), a heightened sensitivity to pain, and/or allodynia to light touch or deep somatic (physical) pressure and/or joint movement
    • Vasomotor: temperature differences between the limb, and/or skin colour changes and/or skin colour changes between the limb
    • Sudomotor/oedema: oedema and/or sweating changes and/or sweating differences between the limbs.
    • Motor/trophic: decreased range of motion and/or motor dysfunction (ie weakness, tremor or muscle spasm) and/or trophic changes (hair and/or nail and/or skin changes)

    Stress and chronic pain

    The fight or flight response is an automatic physiological reaction to an event that is perceived as stressful or frightening, and therefore stress overload is common for sufferers of chronic pain. This can be a vicious circle as stress can exacerbate the pain and chronic pain can also cause an increase in stress.

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  • Who treats CRPS

    Complex Regional Pain Syndrome (CRPS) can affect people of any age, including children, but it tends to be more common in women who are 60 to 70 years of age. Some of the common symptoms include:

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    Symptoms of CRPS

    • Extreme sensitivity to pain that is out of proportion to the injury or trauma
    • Excessive or prolonged pain after contact – as the affected area has increased sensitivity, even light contact can cause extreme pain
    • Continuous pain that gets worse over time
    • Experiencing pain from something that shouldn’t be painful such as a light touch or a change in temperature
    • Stiffness and swelling of the affected joints
    • Changes in skin, hair, and nails – skin may become blotchy, dry, or scaly, nails crack and can become grooved or brittle, and hair often becomes thin
    • A decrease in the range of motion of the affected limb or limbs
    • Stiffness of limbs
    • Insomnia and difficulty sleeping
    • Changes in skin temperature – the affected limb may feel warmer or cooler than the opposite limb
    • Changes in skin texture
    • Tremors and muscle spasms

    These are the most common symptoms experienced by people suffering from CRPS, but it is essential that you seek medical advice rather than making a self-diagnosis. A medical professional can carry out the assessments and tests required to ensure the symptoms you are experiencing are indicative of CRPS.

    CRPS is often very misunderstood and misdiagnosed, which is why it is important to speak to your doctor to discuss a diagnosis. Your doctor will often refer you to specialists including rheumatologists and neurologists to help with your diagnosis and to put together a treatment plan. Physiotherapists, psychologists, occupational health workers as well as pain relief specialists will all work together to support you so you can manage the impact of pain on your life.

    The treatment plan for CRPS

    The treatment plan tends to comprise:

    1. Education and self-management – advice about any steps you can take to help manage the condition
    2. Physical rehabilitation – to help improve your function and reduce the risk of long-term physical problems
    3. Pain relief – treatments to help reduce your pain
    4. Psychological support – interventions to help you cope with the emotional impact of living with CRPS.

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    Budapest criteria

    CRPS is a lifelong condition that is known for being very hard to diagnose and the Budapest Criteria is often used to diagnose CRPS and differentiate between ‘signs’ and ‘symptoms’.

    Symptoms:

    • Sensory – Hyperaesthesia (an abnormal increase in sensitivity), and/or allodynia, which is pain caused by stimuli that shouldn’t trigger a painful response. Examples of allodynia include lightly touching the affected limb, perhaps by moving a bedsheet or by a gentle tap on the wrist.
    • Vasomotor – Skin color changes and/or changes in the temperature of the limb.
    • Sudomotor/edema – Swelling of the limb and/or an excess of sweat from the affected limb, or changes in sweating swelling of the limb.
    • Motor/Trophic – Decreased range of motion and/or motor dysfunction, including weakness, spasms, tremors, or wasting. Trophic changes include changes to the hair, nails, or skin on the affected limb.

    Signs:

    • Sensory: Hyperalgesia (to pinprick), a heightened sensitivity to pain, and/or allodynia to light touch or deep somatic (physical) pressure and/or joint movement
    • Vasomotor: temperature differences between the limb, and/or skin color changes and/or skin color changes between the limb
    • Sudomotor/edema: edema and/or sweating changes and/or sweating differences between the limbs.
    • Motor/trophic: decreased range of motion and/or motor dysfunction (ie weakness, tremor, or muscle spasm) and/or trophic changes (hair and/or nail and/or skin changes)

    Pain is often invisible and the brave face needed to cope with each and every day doesn’t show the internal suffering to others, therefore the sooner you seek help and get a diagnosis and a treatment plan, the sooner you can move forward with your life.

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  • Who does CRPS affect?

    Previously known as Reflex Sympathetic Dystrophy (RSD), Complex Regional Pain Syndrome (CRPS) is caused by an injury to the sympathetic nerves, resulting in severe pain. The condition can be catastrophic, permanent, and disabling.

    CRPS can be difficult to diagnose as there is no single test which can be carried out to give you a yes or no answer. Doctors may carry out the following tests:

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    • Blood tests: carrying out blood tests can discover whether you have an underlying infection causing the pain or rheumatoid arthritis.
    • X-Ray: an x-ray or bone scan on the affected limb can show any problems of bone thinning (osteoporosis) or any other abnormalities with the bones and joints.
    • MRI scan: used to find if there are any other underlying problems with your bones or tissue.
    • Nerve conduction studies: doctors may carry out tests which involve blocking the sympathetic nervous system with an anaesthetic. If they find that blocking this system relieves the pain, then they know they can focus on it as the cause of the pain.

    Budapest Criteria

    The Budapest Criteria is often used to diagnose CRPS and differentiates between ‘signs’ and ‘symptoms’.

    Symptoms:

    • Sensory Hyperaesthesia (an abnormal increase in sensitivity), and/or allodynia, which is pain caused by stimuli which shouldn’t trigger a painful response. Examples of allodynia include lightly touching the affected limb, perhaps by moving a bedsheet or by a gentle tap on the wrist.
    • Vasomotor Skin colour changes and/or changes in the temperature of the limb.
    • Sudomotor/oedema Swelling of the limb and/or an excess of sweat from the affected limb, or changes in sweating swelling of the limb.
    • Motor/Trophic Decreased range of motion and/or motor dysfunction, including weakness, spasms, tremors or wasting. Trophic changes include changes to the hair, nails or skin on the affected limb.

    Signs:

    • Sensory: Hyperalgesia (to pinprick), a heightened sensitivity to pain, and/or allodynia to light touch or deep somatic (physical) pressure and/or joint movement
    • Vasomotor: temperature differences between the limb, and/or skin colour changes and/or skin colour changes between the limb
    • Sudomotor/oedema: oedema and/or sweating changes and/or sweating differences between the limbs.
    • Motor/trophic: decreased range of motion and/or motor dysfunction (ie weakness, tremor or muscle spasm) and/or trophic changes (hair and/or nail and/or skin changes)

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    Types of CRPS

    There are two types of CRPS:

    • type 1, previously known as reflex sympathetic dystrophy or RSD, and
    • type 2, previously known as causalgia.

    The difference between these two types is whether nerve damage is involved.

    Diagnosing CRPS Type 1 is particularly difficult as there is no damage to the nerves and usually no damage to the bone and little damage to the tissue. The pain is out of proportion to the accident or injury that occurred and the main symptoms are usually allodynia, continuing pain, and hyperalgesia, disproportionate pain to touch, movement or pressure.

    CRPS Type 1 is usually diagnosed if the above symptoms are found as well as some kind of oedema, changes to the blood flow (and therefore temperature) in the affected area and other conditions have been ruled out.

    Type 2 is the rarer of the two conditions. CRPS Type 2, formerly known as causalgia, is a severely painful and chronic condition which develops as a result of an injury to a peripheral nerve. The pain associated with CRPS Type 2 is usually described as an intense burning which doesn’t subside and the pain is specific to the affected area, due to the injury to the nerve.

    CRPS Type 2 is different to Type 1 because of the tangible nerve injury which can be found and also because the pain doesn’t migrate from the original site. Whilst Type 1 may result in pain in the whole limb over time, CRPS Type 2 is a condition which remains specific to the original place that was injured.

    CRPS Type 2 is caused by a trauma to a large nerve in one of the limbs, usually in the peripheral nervous system. CRPS Type 2 can be caused by a simple injury or something more traumatic such as a car accident or a fall from a height. The disease progresses over time and can result in loss of movement and mobility in the affected limb, alongside increased pain.

    The symptoms of CRPS Type 2 are quite similar to those of CRPS Type 1 which is why a full diagnosis needs to be carried out by your doctor who may refer you to further specialists to ascertain the exact root cause of the pain. Symptoms of CRPS Type 2 include the burning pain already mentioned as well as sweating, discolouration of the skin in the affected area and hyperalgesia, extreme pain felt from disproportionate action such as light touch, pressure or movement.

    CRPS Type 2 can also change the rate at which hair and nails grow and it’s also more common that the joints in the affected area may seize up or spasm.

    There are no specific tests for CRPS Type 2 and like Type 1 it is mainly diagnosed through symptoms, by professional doctors and specialists who may carry out a range of tests such as MRI scans and blood tests, to rule out other conditions rather than pinpoint CRPS.

    Who can get CRPS?

    CRPS can affect people of any age, including children, but it tends to be more common in women who are 60 to 70 years of age. CRPS is often very misunderstood and misdiagnosed, but in particular, if you develop pain in the aftermath of an injury or trauma that lasts longer than six months, speak to your doctor.

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    For More Information Related to Fibromyalgia Visit below sites:

    References:

    Fibromyalgia Contact Us Directly

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    Official Fibromyalgia Blogs

    Click here to Get the latest Chronic illness Updates

    Fibromyalgia Stores

    Click here to Visit Fibromyalgia Store