|
24 August 2011
Reflex sympathetic dystrophy, also known as complex regional pain syndrome (CRPS), is a chronic pain condition with no known cure. It is most commonly reported in the limbs; often the pain will spread from hand to shoulder, or foot to hip. The severity of the pain without severe injury is one of the telltale symptoms of CRPS.
Other symptoms may include dramatic changes in the color of the affected skin; the skin may also feel incredibly warm. In this area, patients report intense, burning pain, sweating and swelling and general discomfort.
Researchers are still determining the cause of CRPS. Current research shows a link between the condition and an inflammatory response, leading physicians to think it may be an autoimmune condition. Redness, warmth and swelling in the area are all signs of inflammation.
CRPS may be caused from nervous system damage; nerves that control blood vessels and sweat glands may be damaged from trauma, reducing blood flow. This may be responsible for damage found in blood vessels, bones, muscles, the nerves and the skin of CRPS patients. Other possible causes are direct injury to a nerve or an infection in a limb. Also, some cases of heart attack or stroke have shown to cause CRPS.
The average CRPS patient is age 40–60.
While some patients report developing severe CRPS very quickly, typically there are three stages of progression. In the first three months, a patient will notice a change in skin temperature, faster growth of nails and hair, joint pain, a burning aching pain that intensifies with touch and skin that is becoming discolored. During month 3–6, a patient may notice additional changes to the skin coloring, intensified pain, and weak muscles. In the final stage, symptoms are often irreversible. Muscle wasting, limited movement and severe pain are commonly reported. Additionally, patients with CRPS are likely to suffer from depression and anxiety related to their condition.
Treatment options for CRPS vary per patient; because the illness is still not well understood, and there is no known cure, physicians must instead treat the pain. Medications prescribed may include: topical analgesics, antidepressants, corticosteroids or opioids. Unfortunately, there is no known combination of these medications that will provide consistent pain relief for the long term. A pain physician may also recommend physical therapy, a sympathetic nerve block, or a Spinal Cord Stimulation trial.
Spontaneous remission may occur from CRPS. Researchers do not understand what triggers this illness, nor what can make it seemingly disappear overnight. In other patients, the pain will cause debilitating life-long pain. Researchers at the National Institute of Neurological disorders and Stroke continue to research CRPS to better understand the many questions of this condition.
References
- National Institute of Neurological Disorders and Stroke. Complex regional pain syndrome fact sheet. Updated December 21, 2009. Accessed January 19, 2010.
- Saxton DL, Lindenfeld TN. Complications. In: DeLee JC, Drez D Jr., Miller MD, eds. DeLee and Drez's Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier;2009:chap 7.
- www.ncbi.nlm.nih.gov/pubmedhealth
- www.ninds.nih.gov/disorders/reflex_sympathetic_dystrophy/reflex_sympathetic_dystrophy
