Complex regional pain syndrome, abbreviated as CRPS, is defined by the National Institute of Neurological Disorders and Stroke (NINDS) as a chronic pain condition that stems from problems with the nervous system, either the central or peripheral nervous system. The National Institutes of Health (NIH) states that one of two forms of CRPS can occur: type one is a chronic nerve disorder that affects the arms and legs after a minor injury, and type two is from nerve injury. Nerve conditions, like CRPS and neuropathy, affect the body's ability to control movements, sensations and autonomic functions.
The NIH states that a patient with CRPS can go through three stages of the disorder. However, not all patients experience CRPS the same: some patients may stay in stage one, while other patients may have a faster progression.
Stage One
The first stage of CRPS has a month to three months duration. During this stage, the patient has increased hair and nail growth, and dry and thin skin that changes color. Severe pain is also present: the pain moves through the limb, becomes worse when the affected limb is touched, and has a burning or aching sensation.
Stage Two
The second stage of CRPS lasts longer, with a three to six months duration. The hair growth reverses, and the patient has significant changes in her skin texture and color. The swelling also increases, resulting in stiff muscles and joints.
Stage Three
By stage three, the damages from CRPS are irreversible. The pain and muscle problems have become progressively worse, with pain throughout the affected limb, muscle contractions that involve the tendons and muscles, limited movements and muscle wasting. During this phase, the patient can also experience depression or other changes in mood.
The Mayo Clinic notes that the spread of symptoms in CRPS follow one of three patterns: continuity type, mirror-image type and independent type. With continuity type, the pain and muscular problems spread in a logical pattern, such as up the leg to the torso. The mirror-image type pattern results in a spread of symptoms to the opposite limb, while the independent type pattern has the spreading of symptoms to a random part of the body.
The prognosis of CRPS varies. The NINDS states that some patients have spontaneous remission, while others have irreversible damage. While there is no cure, multiple treatment options are available to help control the symptoms. Physical therapy helps with mobility problems, and psychotherapy treats mood problems that result from the disorder. Medications, like topical analgesics, corticosteroids, anti-seizure drugs, antidepressants, and opioids are used for pain management. Other options include sympathetic nerve block, intrathecal drug pump (direct drug administration to the spinal fluid), and spinal cord stimulation. Another treatment, surgical sympathectomy, which destroys the nerves involved in the disorder, is controversial and its effectiveness is debated.
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Elizabeth Stannard Gromisch received her bachelor’s of science degree in neuroscience from Trinity College in Hartford, CT in May 2009. She is the Hartford Women's Health Examiner and she writes about abuse on Suite 101.