Complex Regional Pain Syndrome (CRPS)

Background

Complex regional pain syndrome (CRPS) is a difficult condition to treat and it is not entirely well understood. CRPS is also known as causalgia, reflex sympathetic dystrophy syndrome, and Sudek’s atrophy. There are two types, Type 1 is the commonest and occurs in the absence of a demonstrable nerve lesion. The second type is where there is evidence of damage to an identifiable nerve.

 

Causes

CRPS is complex condition and can occur following trauma or surgery. It is most often seen in the hand but can occur elsewhere. While usually there is no specific nerve injury, on occasion there can be.

 

Symptoms

There can be swelling of the hand with a change in skin colour. There is usually pain out of proportion to what is expected, together with reduced movement of the hand and fingers. Sweat production in the hand can also be affected.

 

Treatment - non-surgical

Special hand therapy and neuropathic (nerve) painkillers are the mainstay of treatment.

 

Treatment - surgical

Surgery only tends to be performed where there is a problem with a specific nerve, such as compression of a nerve causing symptoms. Indeed surgery in someone with CRPS can lead to a worse outcome.

 

Outcome

CRPS is a difficult condition to treat and while the majority of patients do have resolution of their symptoms, some do not. In cases that do have resolution of their symptoms, this can take up to 1 - 2 years.

 

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