What Most People Don't Know About Complex Regional Pain Syndrome

Complex regional pain syndrome (CRPS) is a lesser-known cause of chronic pain among the general population, but it can be a debilitating one. 

The name is an umbrella term describing damage to or malfunction of the nervous system, one that generates prolonged pain and inflammation of a limb (hands, arms, legs, or feet), usually following an injury or surgery. 

People with CRPS often experience spontaneous pain or pain that’s totally out of proportion for the injury sustained.

Board-certified interventional pain specialist Dr. Matthew Crooks and his team at Pinnacle Pain and Spine understand how debilitating chronic pain can be, including pain caused by complex regional pain syndrome. 

Here’s what most people don’t know about CRPS but they should.

The types and causes of CRPS

Most cases of CRPS result from excessive firing of the small, peripheral nerve fibers that carry pain messages from the extremities to the brain. 

The constant firing triggers inflammation intended to help promote healing after an injury, but it also overwhelms the brain with pain signals, increasing your sensitivity. Sometimes the original injury to the nerve(s) is obvious, but sometimes you need a specialist to locate and treat it.

Historically, any time there was a question about the exact nerve injured, people were diagnosed as having CRPS-I. Once the nerve was identified, the diagnosis changed to CRPS-II (causalgia).

Many people labeled with CRPS-II sustain injuries that damage motor as well as sensory nerves, causing weakness and muscle shrinkage in those areas. That makes it easier to identify the nerve(s) responsible for the pain. 

Motor nerves handle muscle movement under conscious control, such as for walking, talking, and grasping things.

Since both types of CRPS result from nerve injury, they have identical symptoms, but those in CPRS-I are often more subtle since the muscles aren’t involved and can be easily overlooked.

Who gets complex regional pain syndrome?

CRPS can develop at any age. But it’s less common in children and teens due to their quick healing abilities, and it’s less common in the elderly, who have a smaller inflammatory response to injuries.

In adults, certain groups are more likely to develop CRPS:

• Those aged 37-70
• Those of European ancestry (about 66-80% of cases)
• Women, who are three to four times more likely to get it than men

It’s unclear, though, why some people develop CRPS while others who sustain the same injury don’t. The most common triggers are fractures, sprains, and soft tissue injuries such as burns and bruises.

What are the symptoms of complex regional pain syndrome?

Not every person develops all of these symptoms, and the number of symptoms usually decreases during recovery. The symptoms may include:

• Pain that’s constant or changes with activity
• Heightened or prolonged pain after use or touch
• Changes in skin temperature and/or color
• Changes in skin texture
• Limb swelling
• Stiffness in affected joints
• Abnormal sweating and nail and hair growth
• Wasting away or excess bone growth

One of the ways of diagnosing CRPS is through a bone scan, as bone metabolism changes are characteristic of the condition.

What treatments help complex regional pain syndrome?

At Pinnacle Pain and Spine, we offer a number of different treatments for CRPS, most used to provide a measure of relief while the body heals itself. These include:

• Physical therapy
• Psychotherapy
• Over-the-counter anti-inflammatory medications
• Topical local anesthetics
• Prescription neuropathic pain meds, opioids, and Botox® injections
• Bisphosphonates (for bone growth) and corticosteroids (for inflammation)
• Spinal cord or other forms of neural stimulation
• Nerve block
• Holistic therapies, including acupuncture, biofeedback, progressive muscle relaxation, and chiropractic treatment

If you’re experiencing pain that seems out of proportion to an injury, or if you have pain but aren’t aware of any injury, you may be suffering from complex regional pain syndrome. 

To learn more and to get effective treatment, schedule a consultation with one of our pain specialists at Pinnacle Pain and Spine. Call us at any of our Arizona locations, or request your appointment online. We have offices in Chandler, Scottsdale, and Fountain Hills, Arizona.