Complex Regional Pain Syndrome

Complex regional pain syndrome, or CRPS, is a painful condition that affects the arms or legs after some form of injury has occurred. CRPS is a diagnosis of exclusion and is characterized by severe pain out of proportion to the initial event. It is also associated with swelling, temperature change, and touch sensitivity of the affected extremity.

Two types of CRPS exist. Type one occurs in the absence of nerve injury while type two occurs after damage to a nerve in the injured arm or leg. Three mandatory diagnostic criteria for the condition of CRPS are described by the International Association for the Study of Pain consensus panel. These include:

• Continuing pain of the arm or leg disproportionate to the initiating event
• Pain associated with changes in skin blood flow, swelling, or abnormal sweating
• No evidence of another condition that could account for the pain or dysfunction

The pain felt with CRPS is out of proportion in intensity, distribution, and duration of what would be expected from the initial injury. The nature of the pain often fluctuates with external stimuli (changes in temperature/touch) and internal stimuli (life stress/illness). Eventually movement can become limited due to pain and muscle weakness and decreased range of motion develops in the affected arm or leg.

Physical therapy plays an important role in the management of CPRS. Common physical therapy goals in this disorder include:

• Desensitization to touch
• Increasing range of motion in the affected limb
• Muscle strengthening

CRPS is a difficult disorder to treat. However with aggressive physical therapy and medical management, a decrease in the pain intensity and functional improvement can occur.

_Source:

Complex regional pain syndrome (CRPS) with resistance to local anesthetic block: a case report . Journal of Clinical Anesthesia , Volume 12 , Issue 1 , Pages 67 - 71 F. Maneksha.