What is complex regional pain syndrome?

Complex regional pain syndrome (CRPS) is a condition that causes pain, swelling, and other symptoms. It usually happens in just one part of the body, such as an arm or leg. It often starts after an injury, surgery, heart attack, or stroke. Doctors are not sure how or why it starts. People who have CRPS have worse pain than doctors would expect from the injury, surgery, or other medical problem. CRPS can also start without any injury or medical problem happening first.

What are the symptoms of complex regional pain syndrome?

Symptoms of CRPS are different depending on how long it lasts.

Symptoms of CRPS can include:

• Pain — The pain can be burning, tingling, throbbing, or aching. It can also be severe.
• Being sensitive to touch or cold
• Swelling in the body part with CRPS
• Skin changes, such as getting thick, rough skin
• Losing muscle size and strength

If CRPS lasts longer than 3 to 6 months, it can cause worse symptoms. These can include:

• Trouble moving the body part that has CRPS
• Fingers, toes, hands, or feet that curl in
• More skin changes, such as skin that looks shiny or changes color
• Fingernails that break easily. They can have lines or ridges on them.
• Sweating when a person is not exercising or hot
• Changes in hair on the head or body
• Coldness of the body part with CRPS
• Urinary problems, such as having to urinate more often or not being able to urinate when you want to
• Sore, tight places in muscles, called “tender points.” (These are common if CRPS affects the shoulder or upper body.)

Is there a test for complex regional pain syndrome?

No. There is not just 1 test doctors can do to find CRPS.

The doctor will do an exam and ask questions. He or she can usually tell if a person has CRPS from the symptoms, medical history, and exam.

If a doctor is not sure if a person has CRPS, he or she might order imaging tests such as a bone scan, X-ray, or MRI. These tests create pictures of the inside of the body. They can show changes to the bones, joints, or skin caused by CRPS.

Doctors can also do tests that measure skin temperature, sweating, and nerve sensitivity. The doctor might do them if he or she needs extra information.

How is complex regional pain syndrome treated?

Treatment for CRPS is different for each person. Treatments for CRPS include:

• Learning about CRPS — For example, it is important to know that even though CRPS hurts, it does not damage the body part. Joining a support group can help a person with CRPS deal with symptoms.
• Talking with a counsellor — This can help reduce stress. Stress at work or home can be part of CRPS or make it worse.
• Physical therapy to learn exercises and stretches, and keep the body part with CRPS working.
• Stopping smoking
• Taking medicines to relieve pain — These can be prescription or over-the-counter medicines, depending on what the doctor or nurse thinks might work best.

If CRPS does not get better with these treatments, doctors can try other things. These include:

• Injections (shots) of numbing or pain-relieving medicines (Nerve blocks)
• Pain-relieving medicine given in the spine (Epidurals, Sympathetic blocks)
• Devices to help stop nerve signals of pain (Spinal cord stimulation)

People with severe CRPS should see a doctor who specializes in treating pain.