Reflex Sympathetic Dystrophy / Complex Regional Pain Syndrome

Reflex Sympathetic Dystrophy / Complex Regional Pain Syndrome

Complex regional pain syndrome (CRPS) is a chronic pain condition characterized by severe pain, swelling, and changes in the skin, such as the pigmentation and/or texture. Previously known as reflex sympathetic dystrophy (RSD), CRPS most commonly develops in an arm or a leg, typically after surgery or as a result of an injury (i.e. a broken bone or sprain); and it may subsequently spread throughout the body.
Other events or conditions that can trigger CRPS include: brain diseases, such as stroke; degenerative arthritis of the neck; and heart disease. Though more uncommon, patients may also experience CRPS without being able to identify the event or injury that triggered it.
There are two types of complex regional pain syndrome:

  • Type 1: Without nerve injury. Most patients are diagnosed with this type.
  • Type 2 (formerly known as causalgia): With nerve injury. This type of CRPS tends to be more painful and is characterized by burning pain.

Symptoms of CRPS/RSD

The pain associated with complex regional pain syndrome is often more severe than what is customary for the initial injury. Symptoms can start out mild or moderate and get worse over time, either gradually or quickly, depending on the patient. The first signs of CRPS are usually pain in the affected arm or leg, redness, swelling, and sensitivity to touch and cold.
Other symptoms of complex regional pain syndrome include:

  • Burning or throbbing pain in the limbs
  • Changes in skin temperature, alternating between sweaty and cold
  • Changes in skin texture (shiny or dry) and/or color (white, blotchy, red or blue)
  • Stiffness in the joints
  • Muscle spasms, weakness, and muscle loss
  • Loss of movement in the affected arm or leg

Symptoms may last for a few months to several years – and they can get progressively worse.

Diagnosis & Treatment

Your doctor will diagnose complex regional pain syndrome based on a physical exam and medical history. The following tests and procedures may also be used to help make a CRPS diagnosis: bone scan to help detect changes in bone density; X-ray to check for loss of minerals in the bones; magnetic resonance imaging (MRI) to identify tissues changes; thermography to measure skin temperature and blood flow; and other sympathetic nervous system tests.
It is possible to recover fully from CRPS if you start treatment early (within months of your first symptoms). At Paradigm Pain and Spine, we tailor treatment plans to meet the individual needs of each patient. Treatment options may include:

  • Pain relievers (over-the-counter and/or opioid)
  • Topical analgesics
  • Physical therapy
  • Spinal cord stimulation
  • Sympathetic block
  • Stellate ganglion block
  • Intrathecal drug pumps
  • Transcutaneous electrical nerve stimulation
  • Other medication (corticosteroids, alpha-blocking drugs, calcium channel blockers)

If you think you might have complex regional pain syndrome (reflex sympathetic dystrophy), contact us to make an appointment with a pain specialist. The earlier you start treatment the more likely it is to be effective.