What is complex regional pain syndrome
Complex regional pain syndrome (CRPS) is a chronic pain disorder. CRPS usually affects an arm or leg after an injury, surgery, heart attack, or stroke.
Symptoms of CRPS
There are two types of complex regional pain syndrome:
Type I—formerly known as reflex sympathetic dystrophy (RSD)—occurs when there’s no known nerve injury.
Type II occurs when there’s a confirmed nerve injury.
CRPS can cause severe burning pain and swelling in the affected area. It most often affects the arms or legs, but it can also affect the skin, muscles, joints, and bones anywhere in your body. The skin on your affected limb may be unusually sensitive to touch and temperature changes and may become shiny and thin in spots. Your hair and nails may grow more slowly than they did before you had the condition. You might also experience muscle spasms and tremors, stiffness or weakness of your limb, decreased range of motion in your joint(s), changes in how you sweat in your affected area (i.e., too much or too little), and changes in how you move your affected limb(s).
What are the symptoms of complex regional pain syndrome
The following symptoms can occur in any affected body part, and they may be more severe in some areas than in others:
- Burning sensations
- Skin changes (color, temperature, texture)
- Muscle spasms
- Muscle weakness
- Loss of range of motion
- Decreased ability to use the affected limb or body part (handicap)
- Irritability and sensitivity to touch or movement
- Fatigue (feeling tired) and insomnia (difficulty sleeping)
What are the treatments for complex regional pain syndrome
Treatment for complex regional pain syndrome (CRPS), also referred to as reflex sympathetic dystrophy (RSD), is best done by a team of health care providers who are skilled in the management of CRPS. This may include physicians and nurses, a physical therapist, psychologist, occupational therapist, and social worker.
There are many treatment options available for people with CRPS. Medications that have been used in treating this condition include:
- analgesics (pain relievers)
- bisphosphonates (a group of agents used to strengthen bones)
- IV immunoglobulin therapy
- calcitonin gene-related peptide inhibitors (an injection given just under the skin that targets the nerves causing the pain signals)In addition to medication therapy, other types of therapies that may be recommended by your health care provider(s) can include:
- physical therapy or occupational therapy
- nerve blocks
- psychological therapy
Some individuals with severe CRPS may find relief from surgery or spinal cord stimulation. Other treatments currently being researched include transcutaneous electrical nerve stimulation (TENS).
What causes complex regional pain syndrome
The most common cause of CRPS is damage to, or malfunction of, the peripheral and central nervous systems. The exact cause of CRPS is unknown. Doctors sometimes call this condition chronic pain syndrome type I or reflex sympathetic dystrophy syndrome (RSDS).
CRPS-I develops after an illness or injury that did not directly damage the nerve in the affected limb. Some examples include fractures, sprains or surgery to an arm or leg. For unknown reasons, the nervous system malfunctions in response to this injury and sends constant pain signals to the brain. The affected part of your body then begins to swell and changes color. It also becomes warmer than normal and very sensitive to touch.
In some cases, CRPS-II occurs after a major injury such as a fracture, crush injury or amputation that directly damaged a nerve in your limb (peripheral nerve injury). In other cases, it follows minor trauma that did not damage any nerves but caused swelling at the site of the trauma (peripheral ischemia).
Several clinical trials to evaluate treatments for complex regional pain syndrome are currently under way.
The Lumbar Spine Review, or the U.S. Food and Drug Administration’s Center for Drug Evaluation and Research, is conducting clinical trials (meaning they’re large scale studies involving human beings) to evaluate the efficacy of five different drugs that may be of help to people suffering from complex regional pain syndrome.
The development of new medications can be a long and complicated process. Clinical trials are a critical step in bringing new drugs to market—and in some cases, these studies may allow for medicine to be approved for use on an even larger scale than originally intended. The FDA’s Center for Drug Evaluation and Research has several ongoing clinical trials being conducted, including those that aim to determine if gabapentin, amitriptyline, pregabalin (or Lyrica), milnacipran (or Savella), and oxaliplatin are effective treatments for complex regional pain syndrome.
Clinical trials are designed to test the safety and effectiveness of new drugs and treatments, as well as other forms of treatment.
The complex regional pain syndrome clinical trials I’m about to describe may seem a little unusual. But don’t let that dissuade you! Clinical trials are designed to test the safety and effectiveness of new drugs and treatments, as well as other forms of treatment (for example, surgeries). Clinical trials have helped scientists learn more about the causes of diseases such as cancer, HIV infection, migraines, and chronic pain. They also help doctors treat people with these conditions—whether it’s for months or years at a time.
A trial can answer lots of questions about drug safety, effectiveness in humans (how well it works), how the drug might interact with other medications the patient is taking, and how the drug compares in terms of cost and side effects to other treatments already on the market (including surgical approaches).
In many cases, the only way to find out if a new treatment works is to try it on volunteers in a clinical trial.
The Federal Food and Drug Administration carefully regulates clinical trials to make sure that new medical treatments are safe and that they work. In fact, in many cases, the only way to find out if a new treatment works is to try it on volunteers in a clinical trial.
You may be eligible for a clinical trial if you meet certain criteria. This criteria can vary by trial and may include age, type of disease, severity of disease, etc. Once you have found a clinical trial, you can talk with your doctor about whether or not it is right for you. If it is not right for you at this time, there may be other research studies available to help you manage your condition or symptom(s).
In some cases, clinical trials provide access to new treatments before they become available to the public. Treatments for complex regional pain syndrome include
There are several medications that have been used to treat complex regional pain syndrome, including antidepressants, anticonvulsants, and strong opioids.
These medications may help with the pain associated with CRPS. However, they may also cause significant side effects or prove ineffective in relieving symptoms.
Other treatment options include steroid injections into the affected area; botox (botulinum toxin) injections in the affected area; spinal cord stimulation; nerve blocks; physical therapy; psychotherapy; and surgery. It is important to discuss these options with a doctor knowledgeable about treating people with CRPS.
Some experimental treatments for CRPS are being evaluated through clinical trials. In some cases, clinical trials provide access to new treatments before they become available to the public.