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.

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.

Symptoms

Symptoms most commonly occur after injury or surgery. Other causes include pressure on a nerve, infection, cancer, neck problems, stroke, or heart attack.

Diagnosis

After discussing your medical history and symptoms, your doctor will carefully examine your hand or affected limb.

People with CRPS are unusually protective of the involved limb. Even a light touch may evoke expressions of severe pain.

Treatment

Early diagnosis and treatment are important in order to prevent CRPS from developing into the later stages.

It is also important that these patients not be told that the pain is “in their heads.” CRPS is a physiological condition. Even though it is not fully understood, CRPS is treatable.

Nonsurgical Treatment

Medications

Non-steroidal anti-inflammatory drugs (NSAIDs), oral corticosteroids, anti-depressants, blood pressure medications, anti-convulsants, and opioid analgesics are medications recommended to relieve symptoms.

Injection therapy

Injecting an anesthetic (numbing medicine) near the affected sympathetic nerves can reduce symptoms. This is usually recommended early in the course of CRPS in order to avoid progression to the later stages.

Therapy

Active exercise that emphasizes normal use of the affected limb is essential to permanent relief of this condition. Physical and/or occupational therapy are important in helping patients regain normal use patterns. Medications and other treatment options can reduce pain, allowing the patient to engage in active exercise.

Surgical Treatment

If nonsurgical treatment fails, there are surgical procedures that may help reduce symptoms.

Spinal cord stimulator

Tiny electrodes are implanted along your spine and deliver mild electric impulses to the affected nerves.

Pain pump implantation

A small device that delivers pain medication to the spinal cord is implanted near the abdomen.

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