Synonym(s): Reflex
Sympathetic Dystrophy Syndrome, Causalgia
Reviewed
07-01-2001
Table of Contents (click to jump to sections)
What is Complex
Regional Pain Syndrome?
Is there any treatment?
What is the prognosis?
What research is being done?
Organizations
Related NINDS Publications and
Information
Additional resources from MEDLINEplus
What is Complex Regional Pain Syndrome?
Complex regional pain syndrome (CRPS) is a chronic condition
characterized by severe burning pain, pathological changes in bone and
skin, excessive sweating, tissue swelling, and extreme sensitivity to
touch. The syndrome is a nerve disorder that occurs at the site of an
injury (most often to the arms or legs). It occurs especially after
injuries from high-velocity impacts such as those from bullets or
shrapnel. However, it may occur without apparent injury. One visible
sign of CRPS near the site of injury is warm, shiny red skin that later
becomes cool and bluish.The pain that patients report is out of
proportion to the severity of the injury and gets worse, rather than
better, over time. Eventually the joints become stiff from disuse, and
the skin, muscles, and bone atrophy. The symptoms of CRPS vary in
severity and duration. The cause of CRPS is unknown. The disorder is
unique in that it simultaneously affects the nerves, skin, muscles,
blood vessels, and bones. CRPS can strike at any age but is more common
between the ages of 40 and 60, although the number of CRPS cases among
adolescents and young adults is increasing. CRPS is diagnosed primarily
through observation of the symptoms. Some physicians use thermography to
detect changes in body temperature that are common in CRPS. X-rays may
also show changes in the bone.
Is there any treatment?
Physicians use a variety of drugs to treat CRPS. Elevation of the
extremity and physical therapy are also used to treat CRPS. Injection of
a local anestheticis usually the first step in treatment. TENS (transcutaneous
electrical stimulation), a procedure in which brief pulses of
electricity are applied to nerve endings under the skin, has helped some
patients in relieving chronic pain. In some cases, surgical or chemical
sympathectomy -- interruption of the affected portion of the sympathetic
nervous system -- is necessary to relieve pain. Surgical sympathectomy
involves cutting the nerve or nerves, destroying the pain almost
instantly, but surgery may also destroy other sensations as well.
What is the prognosis?
Good progress can be made in treating CRPS if treatment is begun early,
ideally within three months of the first symptoms. Early treatment often
results in remission. If treatment is delayed, however, the disorder can
quickly spread to the entire limb, and changes in bone and muscle may
become irreversible. In 50 percent of CRPS cases, pain persists longer
than 6months and sometimes for years.
What research is being done?
Investigators are studying new approaches to treat CRPS and intervene
more aggressively after traumatic injury to lower the patient's chances
of developing the disorder. Scientists are studying how signals of the
sympathetic nervous system cause pain in CRPS patients. Using a
technique called microneurography, these investigators are able to
record and measure neural activity in single nerve fibers of affected
patients. By testing various hypotheses, these researchers hope to
discover the unique mechanism that causes the spontaneous pain of CRPS,
and that discovery may lead to new ways of blocking pain.
Select this link to view a list of studies currently seeking
patients.
Organizations
American Chronic Pain
Association (ACPA)
P.O. Box 850
Rocklin, CA 95677-0850
ACPA@pacbell.net
http://www.theacpa.org
Tel: 916-632-0922 800-533-3231
Fax: 916-632-3208
National Chronic Pain
Outreach Association (NCPOA)
P.O. Box 274
Millboro, VA 24460
ncpoa@cfw.com
http://www.chronicpain.org
Tel: 540-862-9437
Fax: 540-862-9485
Reflex Sympathetic
Dystrophy Syndrome Association (RSDSA)
P.O. Box 502
Milford, CT 06460
info@rsds.org
http://www.rsds.org
Tel: 203-877-3790
Fax: 203-882-8362
American RSDHope Group
P.O. Box 875
Harrison, ME 04040-0875
rsdhope@mail.org
http://www.rsdhope.org/
Tel: 207-583-4589
National Foundation for
the Treatment of Pain
1330 Skyline Drive
#21
Monterey, CA 93940
markgordon@paincare.org
http://www.paincare.org
Tel: 831-655-8812
Fax: 831-655-2823
American Pain Foundation
201 North Charles Street
Suite 710
Baltimore, MD 21201
info@painfoundation.org
http://www.painfoundation.org
Tel: 888-615-PAIN (7246) 410-783-7292
Fax: 410-385-1832
National Headache
Foundation
820 N. Orleans
Suite 217
Chicago, IL 60610-3132
info@headaches.org
http://www.headaches.org
Tel: 773-388-6399 888-NHF-5552 (643-5552)
Fax: 773-525-7357
Mayday Fund [For Pain
Research]
c/o SPG
136 West 21st Street, 6th Floor
New York, NY 10011
MaydyFnd@aol.com
http://www.painandhealth.org
Tel: 212-366-6970
Fax: 212-838-2896
International Research
Foundation for RSD/CRPS
USF Medical Clinics
12901 Bruce Downs Blvd. MDC33
Tampa, FL 33612
info@rsdfoundation.org
http://www.rsdfoundation.org
Tel: 813-907-2312
Fax: 813-994-8446
Related NINDS Publications and
Information
Reflex Sympathetic Dystrophy
Syndrome Fact Sheet
Complex Regional Pain Syndrome (CRPS)/Reflex Sympathetic Dystrophy
Syndrome fact sheet compiled by the National Institute of Neurological
Disorders and Stroke (NINDS).
La Distrofia Simpática
Refleja/El Síndrome de Dolor Regional Complejo
Informacion de la Distrofia Simpática Refleja/el Síndrome de Dolor
Regional Complejo/Spanish-language fact sheet on Reflex Sympathetic
Dystrophy Syndrome/Complex Regional Pain Syndrome (RSDS/CRPS), compiled
by the National Institute of Neurological Disorders and Stroke (NINDS).
Chronic Pain Information Page
Chronic pain information page compiled by the National Institute of
Neurological Disorders and Stroke (NINDS).
Pain: Hope Through Research
Information booklet on pain compiled by the National Institute of
Neurological Disorders and Stroke (NINDS).
Reflex Sympathetic Dystrophy/
Complex Regional Pain Syndromes (CRPS): State-of-the-Science
A workshop on Reflex Sympathetic Dystrophy/ Complex Regional Pain
Syndromes (CRPS): State-of-the-Science, December 15, 2001.
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should be obtained through consultation with a physician who has
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history.
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