Complex Regional Pain Syndrome

What is CRPS?

Complex regional pain syndrome (CRPS) is a chronic pain condition which is intense and out of proportion to the severity of the injury and gets worse rather than better over time. CRPS most often affects one of the arms, legs, hands, or feet.  Often the pain spreads to include the entire arm or leg.  Typical features include dramatic changes in the color and temperature of the skin over the affected limb or body part, accompanied by intense burning pain, skin sensitivity, sweating, and swelling.  Doctors aren’t sure what causes CRPS.  In some cases the sympathetic nervous system plays an important role in sustaining the pain.  Another theory is that CRPS is caused by a triggering of the immune response, which leads to the characteristic inflammatory symptoms of redness, warmth, and swelling in the affected area.

Management

Because there is no cure for CRPS, treatment is aimed at relieving painful symptoms.  Doctors may prescribe topical analgesics, antidepressants, corticosteroids, and opioids to relieve pain.  However, no single drug or combination of drugs has produced consistent long-lasting improvement in symptoms.  Other treatments may include physical therapy, sympathetic nerve block, spinal cord stimulation, and intrathecal drug pumps to deliver opioids and local anesthetic agents via the spinal cord.

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