Complex regional pain syndrome (CRPS), previously known as Reflex Sympathetic Dystrophy (RSD), is a chronic pain condition. The main symptom is continuous, intense pain that is out of proportion to the severity of the initial injury. The pain occurs after an injury and typically gets worse rather than better over time. It most often affects an arm, leg, hand or foot. CRPS is most common in people aged 20–35; however, it can also affect children and teens. The syndrome occurs more frequently in females than males.
Unfortunately, there is not a clear understanding of the cause of CRPS at this time. It is thought that the sympathetic nervous system plays a role in sustaining the pain of CRPS. Another theory is that CRPS is caused by an abnormal response by the immune system.
The main symptom of CRPS is constant, intense pain. Other symptoms include changes in the color and/or temperature of the skin over the affected area, tingling and numbness, swelling or stiffness in the affected joint, changes in nail or hair growth patterns and a limited ability to move the affected area of the body. The symptoms of CRPS vary from person to person in both severity and length.
Your doctor will take a thorough history and do a physical exam. The diagnosis is based on the history and examination. There is no specific diagnostic test for CRPS. Blood tests and imaging studies (X-rays, MRI, etc.) may be done to rule out other conditions.
Treatment for CRPS is aimed at relieving the pain. This treatment is most effective if it is started early in the course of the condition. Therapies include medications, such as topical pain relievers, narcotics, steroids and anti-seizure medicines, in addition to physical therapy, nerve blocks, spinal cord stimulation and medicine pumps. CRPS is most often managed by doctors who specialize in pain control.
The amount of time it takes to recover from CRPS varies from person to person. Spontaneous relief of symptoms occurs in some individuals; however, others can have chronic pain and irreversible changes in their skin and hair patterns in spite of treatment. The affected area should be pain-free with daily activities before returning to sports.
*CRPS is a relatively new diagnosis in children and research is underway to further understand the cause and to provide improved treatment. For more information, please visit rsds.org.