Complex regional pain syndrome, or CRPS, is a relatively recent name for related conditions that have been known by other names in the past, such as “reflex sympathetic dystrophy” (RSD) and “causalgia.” What was often referred to as RSD in the past is now more commonly known as “CRPS-I,” and what was called causalgia is now more typically referred to as “CRPS-II.” Other names have included reflex neurovascular dystrophy, algoneurodystrohpy, sympathetically maintained pain, and Sudek’s syndrome. As might be guessed from the many names for these associated conditions, they are complicated and often not well-understood. They generally involve trauma to the peripheral nerves and have symptoms involving the sympathetic nervous system.
CRPS-I or RSD, can result from even very minor injuries, with no apparent nerve damage — in many cases people may not even recall a specific traumatic event when the complex regional pain syndrome symptoms show up weeks or months later. Fractured limbs, contusions, and even minor surgical procedures can result in the onset of CRPS-I symptoms, which often include a severe burning pain in the limb that is made worse with movement or by touching the limb. Other symptoms can include increased sweating and skin temperature in the affected area, and sometimes swelling. Long term symptoms can include skin constriction and reduced temperature in the limb. The skin, soft tissues and bone can atrophy, and the bone may develop osteoporosis.
CRPS-II or causalgia, results from a direct injury to a nerve, most often the median or ulnar nerves in the arms or the tibial or sciatic nerves in the legs. Like the RSD version of complex regional pain syndrome, CRPS-II may not appear until months after the injury, however it can also appear very quickly. As with CRPS-I it commonly involves a constant burning pain that is worsened with movement and contact with the skin. Temperature and sweating changes are also present in the skin, and long-term consequences include atrophy of the bones, muscles and joints in the affected limb. CRPS-II symptoms are typically seen only in the “distribution” of the injured nerve, that is, within the parts of the limb that are served by that nerve. This is unlike CRPS-I symptoms that usually affect an entire foot, hand, leg or arm.
Complex regional pain syndrome is typically treated by neurologists and/or pain management specialists. Sympathetic nerve blocks and physical therapy can sometimes help, more commonly with CRPS-II. Often mental health professionals will also become involved to help the patient cope with the severe pain — pain from complex regional pain syndrome is not only chronic, it is also often described as one of the most painful conditions a person can suffer from.
If you or a loved one has suffered a traumatic injury caused by negligence, especially one that has caused a condition that can be as devastating as complex regional pain syndrome, call me now at (916) 921-6400. If you are outside the Sacramento area, you can call at (800) 404-5400 for free, friendly advice.