Complex Regional Pain Syndrome

• Severe pain that is seemingly out of proportion to what is expected
• Persistent swelling of the affected limb, longer or more than expected
• Severe stiffness of the joints of the affected limb
• Skin changes of the affected limb (color, temperature, texture, hair)

The exact cause of CRPS is unknown. Injuries or surgeries of the hand/wrist and foot/ankle seem to be the most common triggers, and sometimes the injury or surgery can be quite minor. Symptoms may involve the entire affected limb, even though only part of the limb was originally injured.

There is no single test to confirm CRPS. The diagnosis is usually based on clinical observations and a physical exam. Sometimes x-rays, MRI, or nerve testing can provide additional information, but they rarely confirm or exclude the diagnosis of CRPS on their own.

You should seek care as soon as possible for symptoms of CRPS. Unfortunately, there is no single treatment that fully cures CRPS, though we can recommend a wide spectrum of treatments if we suspect CRPS. Symptoms can be very slow to resolve, even with treatment, and sometimes chronic pain or stiffness can develop as a result.

Nonoperative treatment

Gentle hand therapy is often used to gradually restore joint mobility and strength. Proceed cautiously as aggressive therapy may actually cause CRPS to flare up. Medications may reduce pain/swelling or help regulate nerve dysfunction, but these rarely provide sufficient relief of symptoms on their own. Psychotherapy may help with coping skills. Pain Management specialists will sometimes perform nerve injections to help regulate nerve dysfunction.

Operative treatment

Surgery is rarely recommended for CRPS unless a nerve injury or compressed nerve is triggering the CRPS, as it may actually worsen symptoms or cause a relapse if you have a history of CRPS.