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Complex Regional Pain Syndrome

The Basics

Written by the doctors and editors at UpToDate пїЅ пїЅ

What is complex regional pain syndrome? " пїЅ Complex regional pain syndrome (CRPS) is a condition that causes pain, swelling, and other symptoms. It usually happens in just one part of the body, such as an arm or leg. пїЅ пїЅ

Both adults and children can get CRPS. In adults, it often starts after an injury, surgery, heart attack, or stroke. Doctors are not sure how or why it starts. People who have CRPS have worse pain than doctors would expect from the injury, surgery, or other medical problem. CRPS can also start without any injury or medical problem happening first. пїЅ пїЅ

What are the symptoms of complex regional pain syndrome? " пїЅ Symptoms of CRPS are different depending on how long it lasts. The symptoms are also different for adults and children. пїЅ пїЅ

Adult symptoms of CRPS can include: пїЅ пїЅ

  • Pain " пїЅ The pain can be burning, tingling, throbbing, or aching. It can also be severe.
  • Being sensitive to touch or cold
  • Swelling in the body part with CRPS
  • Skin changes, such as getting thick, rough skin
  • Losing muscle size and strength

If CRPS lasts longer than 3 to 6 months, it can cause worse symptoms. These can include: пїЅ пїЅ

  • Trouble moving the body part that has CRPS
  • Fingers, toes, hands, or feet that curl in
  • More skin changes, such as skin that looks shiny or changes color
  • Fingernails that break easily. They can have lines or ridges on them.
  • Sweating when a person is not exercising or hot
  • Changes in hair on the head or body
  • Coldness of the body part with CRPS
  • Urinary problems, such as having to urinate more often or not being able to urinate when you want to
  • Sore, tight places in muscles, called "tender points. " пїЅ (These are common if CRPS affects the shoulder or upper body.)

In children, CRPS is most common in the legs. Children with CRPS can have the following symptoms: пїЅ пїЅ

  • Pain, even from something that does not normally cause pain. For example, a child with CRPS might feel pain from a light, gentle touch or just from wearing clothes on the affected body part.
  • Being sensitive to touch or cold
  • Trouble moving the affected body part
  • Sleep problems
  • Coldness, changes in skin color, swelling, or sweating in the body part with CRPS

A child with CRPS might hold the body part that hurts in a strange position. пїЅ пїЅ

Is there a test for complex regional pain syndrome? " пїЅ No. There is not just one test doctors can do to find CRPS. пїЅ пїЅ

The doctor or nurse will do an exam and ask questions. He or she can usually tell if a person has CRPS from the symptoms, medical history, and exam. пїЅ пїЅ

If a doctor is not sure if a person has CRPS, he or she might order imaging tests such as a bone scan, X-ray, or MRI. These tests create pictures of the inside of the body. They can show changes to the bones, joints, or skin caused by CRPS. пїЅ пїЅ

Doctors can also do tests that measure skin temperature, sweating, and nerve sensitivity. These tests are not usually needed. The doctor might do them if he or she needs extra information. пїЅ пїЅ

For children with CRPS, doctors might do blood tests and imaging tests to make sure a different condition is not causing the symptoms. Once the doctor or nurse knows a child has CRPS, other tests are not usually needed. пїЅ пїЅ

How is complex regional pain syndrome treated? " пїЅ Treatment for CRPS is different for each person. Doctors can try different treatments to see what works best. пїЅ пїЅ

For adults, treatments for CRPS include: пїЅ пїЅ

  • Learning about CRPS " пїЅ For example, it is important to know that even though CRPS hurts, it does not damage the body part. Joining a support group can help a person with CRPS deal with symptoms.
  • Talking with a counselor " пїЅ This can help reduce stress. Stress at work or home can be part of CRPS or make it worse.
  • Physical therapy to learn exercises and stretches, and keep the body part with CRPS working.
  • Stopping smoking
  • Taking medicines to relieve pain " пїЅ These can be prescription or over-the-counter medicines, depending on what the doctor or nurse thinks might work best.

If CRPS does not get better with these treatments, doctors can try other things. These include: пїЅ пїЅ

  • Injections (shots) of numbing or pain-relieving medicines
  • Pain-relieving medicine given in the spine
  • Devices to help stop nerve signals of pain

People with severe CRPS should see a doctor who specializes in treating pain. пїЅ пїЅ

The main treatments for children with CRPS include: пїЅ пїЅ

  • Physical therapy
  • Counseling to reduce stress. Working with a counselor is also important to treat mental or emotional problems that could be part of CRPS.

Can complex regional pain syndrome be prevented? " пїЅ Sometimes. In adults who have a stroke, heart attack, or injury, keeping a body part moving can help prevent CRPS. For example, if someone with a stroke is partly paralyzed, a nurse or physical therapist can gently move the paralyzed parts of his or her body. This can be done even if the person cannot get out of bed. пїЅ пїЅ

Breaking a wrist can raise the chance of getting CRPS. If you break your wrist, move it as soon as the doctor says it is safe to do so. This can help prevent CRPS. A physical therapist can teach you exercises and stretches to help the wrist get better. Taking Vitamin C can also help prevent CRPS after a broken wrist. пїЅ пїЅ

All topics are updated as new evidence becomes available and our peer review process is complete. пїЅ пїЅ

This topic retrieved from UpToDate on: Nov 04, 2014. пїЅ пїЅ

Topic 82943 Version 3.0 пїЅ пїЅ

Release: 22.8 - C22.208 пїЅ пїЅ

пїЅ пїЅ 2014 UpToDate, Inc. All rights reserved. пїЅ пїЅ

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пїЅ пїЅ 2014 UpToDate, Inc. All rights reserved. пїЅ пїЅ