Chronic regional pain syndrome (CRPS) is a rare form of chronic pain that typically affects an arm or leg. CRPS usually occurs after an injury, a surgery, or a stroke. There are two types. CRPS I, also known as reflex sympathetic dystrophy (RDS) occurs after an injury that did not directly involve a nerve. CRPS II, also known as causalgia, occurs after a distinct nerve injury.
Symptoms of CRPS
Signs and symptoms of CRPS typically include several of the following in the affected area:
- Sensory:
- Pain to light touch or temperature sensation
- Exaggerated pain to normally tolerable pain (such as a pinprick)
- Vasomotor:
- Changes in temperature to the affected area, or skin color changes
- Sudomotor/edema:
- Edema and/or sweating changes or sweating asymmetry
- Motor/trophic:
- Decreased range of motion of the affected limb
- Weakness, tremor of the affected limb
- Muscle spasms or atrophy
- Changes in the hair, nails, or skin of the limb
Treatment for CRPS
The foundation of treatment is physical therapy. This is essential in order to prevent the decreased range of motion, weakness, and muscle atrophy, that can lead to lasting disability.
Pain relievers, such as NSAIDs can be helpful. Often, prescription medications are required. Some example would be gabapentin and pregabalin, which are nerve pain medications. Many other medications have been used as well.
Spinal Cord Stimulation
One of the most effective treatments is spinal cord stimulation. This involves placing leads that lightly stimulate the spinal cord to block pain signals from the painful limb to the brain, where pain is processed. This process starts with a trial period, typically of 7 days, where the device is placed. This is done in the office as an out-patient procedure. If you experience pain relief, this device can be implanted, which is done at a surgical center as an out-patient procedure.
Spinal cord stimulation is an effective treatment, but it is not the first-line treatment. It is important to see a pain physician early so that you can try other treatments first. It’s important not to wait! As symptoms progress, people with CRPS often experience so much muscle wasting and decreased range of motion that any type of therapy is very difficult. This is why it’s important to seek treatment early.