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Complex Regional Pain Syndrome

After 22 years as an RN, I now write about medical issues and new medical advances. Diet, exercise, treatment, and lifestyle are important.

Severe CRSP


Complex Regional Pain Syndrome

Complex regional pain syndrome (CRPS) is an uncommon nerve disorder, and the cause of this syndrome is not well understood. The intense pain typically affects one of your extremities or your feet. If you suffer from this type of pain it typically follows some type of serious injury. The pain is much more extreme than you would expect following such an event.

The most common symptoms are an intense burning pain in the affected area, extreme skin sensitivity and a dramatic change in the temperature and color of your skin. The most common age range for this condition is 25-55 years old, and CRPS is three times more likely to happen to women. Anywhere from 3 to 6 million Americans suffer from this syndrome.

Serious Chronic Regional Pain Symptoms

Improvement in your pain or remission is possible, but treatment is difficult without an understanding of the cause. According to Mayo Clinic other typical symptoms include:

  • Swelling in the area of pain.
  • The skin may turn different colors, from white to a mottled red or blue. This is similar to Raynaud’s Disease.
  • Changes in the texture of the skin may occur. The skin may become tender, shiny or thin in the painful areas.
  • The hair or nails may grow too fast or too slow.
  • Stiffness, swelling or damage to a joint is not uncommon.
  • Muscle spasms may occur, then weakness and eventually atrophy.
  • There may be a decreased ability to move the affected area of the body.

If this syndrome continues the other symptoms listed above occur, and then, the condition is usually irreversible.

There are times when this chronic pain syndrome leaves on its own without treatment. If treatment is started early in the course of this syndrome there is an improved chance of recovery.

Types of Complex Regional Pain Syndrome

Complex pain actually has two types. Approximately 90% of the people with this syndrome have Type 1, which is known as reflex sympathetic dystrophy syndrome. Type 1 occurs after an injury or illness that did not actually damage a nerve in the affected limb.

Type 2, causalgia, has distinct nerve damage. This type may occur after a traumatic or crushing injury, and it sometimes occurs after an amputation. It can also happen after a heart attack, a stroke, an injection, surgery or even a sprained ankle. Emotional stress can also impact this syndrome.

It is thought that the cause of this condition is due to dysfunction between the central and peripheral nervous systems, thus it is an inflammatory response. Some of the worst case scenarios include muscle contractures, which you see quite often after strokes.

It may also cause tissue wasting. If you have an extremity that is extremely painful and you tend not to move that extremity therefore, the muscle is not being used. Eventually, you will experience stiffness in the muscles, along with the skin and bones.

Complex Regional Pain Syndrome (CRPS)

How is the Diagnosis Made?

There is no simple test that will confirm this diagnosis. When you present to the doctor with the above symptoms, the most common tests ordered are a bone scan, an MRI, X-rays and Sympathetic Nerve System tests.

Injection for Ganglion Nerve Block


Pain Treatment

When treatment is started within a few months of the first symptoms, you will likely improve and remission is possible. Treatment depends on the severity of the symptoms. Treatment is focused on relieving the pain.

Pain relievers that are over-the-counter medications, which are anti-inflammatory, such as Aleve or ibuprofen may help relieve some discomfort. Sometimes, antidepressants or medications that treat seizures are used to treat a damaged nerve. Steroids are also used to reduce inflammation, which will improve mobility. If warranted, the affected area will be injected with an anesthetic to block pain fibers in the affected nerves.

Other types of treatments that may be used are applying heat or cold. Topical analgesics, such as lidocaine, may help reduce the hypersensitivity. Physical therapy can also be helpful.Transcutaneous electrical nerve stimulation (TENS unit) may relieve the pain, as it sends little electric signals to nerve endings.

Biofeedback will teach you to become more aware of your body and enable you to relax your body, which will relieve the pain. Finally, spinal cord stimulation is used. This is where tiny electrodes are inserted along the spinal cord, which sends a small electric current to the spinal cord and effectively relieves the pain.

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If a nerve is compressed, sometimes surgery will relieve the problem. Many people go to a pain clinic to find relief for their pain.

Tens Unit Electrode Placements


Coping with Chronic Pain

Chronic pain is much more difficult to endure than acute pain due to its persistence. Different people have various emotional responses to the intensity of pain and different thresholds of pain tolerance as well. Sadness is certainly common and depression may set in also. If you become hopeless, this is self-destructive.

If chronic pain endures over a long period of time it is not uncommon to go through the grief process, as you are now dealing with the realization that your life has forever changed. That type of change is difficult for most people. CRPS tends to have a profound psychological effect on the patient on the family.

What is Complex Regional Pain Syndrome?

In Conclusion

Living with chronic pain not only affects you on many levels, but your loved ones are also affected. It is very important to have support from your family and friends. If you can reach a point of acceptance, this will benefit you in many ways.

You will be able to better adjust to your limitations and perhaps find things to keep your interest that are physically possible to accomplish. It is important to ask questions of your doctor and be involved in your plan of care. This will help you feel like you have more control over your life.

The National Institute of Neurological Disorders and Stroke (NINDS) is currently doing research on chronic pain that involves the brain and nervous system. There is certainly more research necessary for complex regional pain syndrome. Chronic pain management is unique to each individual.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.


Pamela Oglesby (author) from Sunny Florida on August 25, 2020:

Hi Doris,

You have really had too many painful health problems! I am surpirsed the liocaine patches worked to actually stop the pain for the most part. I am glad things are better for you. Thank you so much for sharing your experience and for all of your comments.

Doris James MizBejabbers from Beautiful South on August 24, 2020:

Pamela, I just now discovered this article because we hadn't met (on HP) when you first published it. My doctor (now deceased) diagnosed me with the Type 1 RSD right after I received a spinal injury in a city bus rollover in 2006. He said he recognized it because he had it in a leg after a motorcycle accident. He prescribed Lyrica, which worked perfectly until the side effects and the detrimental effects on my pocketbook even with insurance were more than I could stand. I was about to ask him if I had fibromyalgia when he came with with this diagnosis of CRPS.

The pain would come from the nerves in my spine and run across my back down both arms to about my elbows. At first I tried to massage it away, but massage, heat, all that was no good. After I gave up Lyrica, I started using lidocaine patches. The longer I used them, the longer the period between attacks became. It seemed like they were permanently quieting my nerves. Today I occasionally use a patch. Maybe once a month or so, and acetaminophen is effective for my back pain.

So after reading your article, I'm not sure that my doctor's diagnosis was correct. I just know that my treatment worked and I'm thankful.

Pamela Oglesby (author) from Sunny Florida on April 27, 2020:

Hi Peggy, Thank you for your comments on so many on so many of my articles. I try to make them thorough. Have a good week Peggy, and, of course, you stay safe too.

Peggy Woods from Houston, Texas on April 27, 2020:

Your articles always keep us informed about many medical topics. Hope this is a good day for you, Pamela. Stay safe!

Pamela Oglesby (author) from Sunny Florida on February 14, 2020:

Happy Valentine's day, Eric.

I don't think ignoring the symptoms will make the condition worse. I do hope your doctors are addressing all of your problems. A pain specialist should be able to help if you haven't tried that.

I am blushing over your angel remark, but you know I do think a lot of you. Yesterday was one of my better birthday as almost all of my family called me. I had so many well-wishers here on Hubpages and I got birthday cards in the mail. I am not sure how everyone knew it was my birthday. When is yours?

Eric Dierker from Spring Valley, CA. U.S.A. on February 14, 2020:

Very interesting. My hands can fit into this too well. Except it is intermittent. Strange but due to rigorous exercise other stuff hurts worse so until more I will just ignore it. (oops, can that make it worse?)

I chose here to comment on the morning after. After your huge birthday party. /maybe small by counting names/ but huge to all of us who know you. I actually was unaware that Angels had birthdays. So thank you for proving it so.

Pamela Oglesby (author) from Sunny Florida on January 13, 2020:

Hi MG Singh, This is not a very common cyndrome, thank goodness. I appreciate your comments.

MG Singh emge from Singapore on January 13, 2020:

Very informative and educative.This is a alien subject for me.

Pamela Oglesby (author) from Sunny Florida on January 13, 2020:

Hi Lora, I hope this article gives your friend some ideas for treatment. She may need to see a pain doctor as it sounds like she has sciatica.

Thank you for your very generous comments.

Lora Hollings on January 12, 2020:

Excellent article, Pamela. I will have to send this to a friend who sounds like she might have this as she has been having a lot of burning pain in her left leg and foot and has been unable to get any relief from the ibuprofen that she has been taking. I will refer her to your article which covers this topic so thoroughly and the available treatments that could offer her a much better way to manage her pain. Great job!

Jim Laughlin from Connecticut on March 14, 2017:

Pamela, you mention in your article that it could 'leave on its own', this is technically not true. There is no cure for this disease although it may go into remission, which is not leaving on its own. It is true that after remission it may never return but it can come back. I do not want to sound argumentative, not my intention. I have this disease and want people to be well informed. Thanks. Good article.

Jim Laughlin from Connecticut on March 13, 2017:

I have suffered from CRPS for almost 3 years. It is a nightmare. I have a HUB written on the subject and I am have also started a blog to share my story and perhaps help other people with the disease.

Your Hub is very good, thank you for writing it.

Pamela Oglesby (author) from Sunny Florida on September 28, 2013:

Majidsiko, That is a shame as the people with this pain really suffer. Thanks for your comments.

Majidsiko from Kenya on September 28, 2013:

Thanks for this ypu wirte very insightful hubs. These pain syndromes are very difficult to diagnose. I have seen patients being treated as psychiatric patients when doctors can't figure out what's going on. They can be quiet debilitating.

Pamela Oglesby (author) from Sunny Florida on July 12, 2012:

Kims, I very much appreciate your comments.

kims3003 on July 12, 2012:

One of the best I have seen written about this condition!!

Pamela Oglesby (author) from Sunny Florida on June 06, 2012:

donnaMhicks, You might also consider seeing a rheumatologist if this doctor doesn't work out. The problem is there are no good medications that treat the problem, only the symptoms. I recently started talking Cymbalta for burning pain is my feet, legs and hands and it took a little over 2 weeks for it to ease the pain, but now things are better. I don't know if that would help you, but I hope this new doc helps. Thanks for your comments and let me know if you like the new doctor.

donnaMhicks on June 05, 2012:

Outstanding hub! I have arthritis in both feet and Raynauds, with symptoms much worse in left foot. My docs in the past have been the kind who treat you like you're stupid and after telling them the symptoms/issues, they say something like "here's your appointment slip to come back in 90 days - see you then." Doc gets paid for nothing and patients still suffer and have no clue what to do. Hopefully, the "specialized ortho" doc I see next wk will be better; I'll be armed with info from this hub. Thanks much-voted up!

Pamela Oglesby (author) from Sunny Florida on May 26, 2012:

lord de cross, There is a 12 week program for Vets suffering from PTSD and chronic pain, which teaches teaches soldiers to re-introduce activities as tolerated and they are taught relaxation techniques also. I never found any statistical information about for vets and chronic. You ask some good questions about history and how the pain might have evolved. I would like to know also. I appreciate your comments.

Joseph De Cross from New York on May 25, 2012:

Completely useful; was wondering if statistics from war veterans can point to this Chronic pain syndrome. Now we wonder, again, if back on the days of Charlemagne (850 A.D) or Napoleon (1815) the Human complexity of pain and diagnosis... was similar, or in earlier chronic stages that evolved with us as society..?

Pamela Oglesby (author) from Sunny Florida on May 25, 2012:

Rosemary, This is rare but so often rare diseases go undiagnosed, so I thought this was a good topic. Thank you so much for your comments.

Rosemary Sadler from Hawkes Bay - NewZealand on May 24, 2012:

I hadn't heard of this before but you have done a wonderful job of providing the information and making people aware of CRPS. I am sure there are those who will identify with this and find answers they were looking for.

Interesting and useful

Pamela Oglesby (author) from Sunny Florida on May 23, 2012:

Ruby, I hope this hub will help them also. Thank you so much for your comments.

Ruby Jean Richert from Southern Illinois on May 23, 2012:

This is very interesting and helpful. I know people who live with chronic pain, hopefully this will help them. Thank's for sharing. Your research on this is outstanding.

Pamela Oglesby (author) from Sunny Florida on May 23, 2012:

teaches, It is so difficult for people living with that type of pain and I wish no one had to suffer like that. Thanks for your comments.

Dianna Mendez on May 23, 2012:

I know people who have to live with pain and have electrode treatments on a monthly basis. It is something they live with, but I wish they didn't have to do so. Thanks for education on chronic pain treatments.

Pamela Oglesby (author) from Sunny Florida on May 22, 2012:

Susan, I don't mind at all. I'm sorry to hear you have been going through this as it certainly sounds painful. I'm glad it is better and I appreciate you sharing your experience.

Susan Zutautas from Ontario, Canada on May 22, 2012:

Pam, I was just about to do a hub on this and as I was putting in the title, it would not let me have it. So I did a search and found your hub. When I fractured my fibula bone back in October the end result was CRPS. To make a long story short I've been having acupuncture along with physio therapy. It has gotten better than it was but I still have a long way to go. If you don't mind I'd like to add a link to a hub I wrote because you've explained this condition so well.

Up, and very useful!

Pamela Oglesby (author) from Sunny Florida on May 22, 2012:

mwilliams, I like to write articles to raise awareness, as so many people have undiagnosed diseases anymore. Having had that experience in my lifetime gives me an incentive to write. Thank you for your comments.

Pamela Oglesby (author) from Sunny Florida on May 22, 2012:

sky2day, I agree that God is surely not short of miracles. I sure hope you receive one, then your pain will be relieved. I appreciate your sweet comments, not to mention the compliments. Love ya back.

mwilliams66 from Left Coast, USA on May 22, 2012:

A very interesting and educational hub. It's wonderful that you are taking the time to raise awareness.

skye2day from Rocky Mountains on May 22, 2012:

Pamela99 No mistake I landed here girl. Yikes my hip and low back over a period of several months has increased in pain. As much as I am praying this is not so many of the symptoms are close to identical. I will keep praying sister!! God is not short of miracles. I am grateful to have landed here. Know this has helped me to gain some understanding.

Your writing is very good and flows right along. You done good for 4:30 AM (0; You could be writing in medical journals. TEE HEE Thank you sister for a ton of great info. Love ya.

Pamela Oglesby (author) from Sunny Florida on May 21, 2012:

This is rare, but I think it always good to be aware of medical issues. I appreciate your very nice comments.

anglnwu on May 21, 2012:

Lots of facts regarding Complex Regional Pain syndrome. I have not heard of it but am glad to be able to learn from the best. Thanks and rated up.

Pamela Oglesby (author) from Sunny Florida on May 21, 2012:

JY3502, Thank you for your comments advice. I shouldn't post a hub at 4:30 AM when I can't sleep!

Pamela Oglesby (author) from Sunny Florida on May 21, 2012:

joanveronica, I'm glad the hub was helpful to you. I know it is difficult to live with chronic pain. I appreciate your comments.

John Young from Florence, South Carolina on May 21, 2012:

Very interesting article Pam. Some good information and well written. But check your copy one more time.

Joan Veronica Robertson from Concepcion, Chile on May 21, 2012:

This was very interesting, I must study it further! It just could be possible I have some of the characteristics! This would answer several mysteries in my life of pain. Very interesting, well written Hub. Voted up, useful and interesting

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