Complex Regional Pain Syndrome (CRPS) 101

September is Pain Awareness Month.

Complex regional pain syndrome (CRPS) is a lot like it sounds and is a broad term for a wide range of conditions causing pain.

The chronic pain condition usually causes long-lasting intense pain, swelling, sensitivity to touch or cold, and other symptoms in extremities — the arms, hands, legs and feet — although it can happen anywhere in the body.

CRPS is typically triggered after an injury or serious medical event that affects the nerves in the body. But, of course, it’s not that simple. Some cases of CRPS happen without a known injury. And CRPS is more common in women and people assigned female at birth (AFAB), but research is ongoing as to why this is. CPRS is usually diagnosed among people ages 50 to 70, making this another condition seen more commonly among women after menopause. It is unusual for CPRS to occur in people who are older than 70.

Pain is complicated, but recovery is possible for many people with CRPS.

Here’s what you should know about symptoms, risk factors and treatment options for complex regional pain syndrome.

Read: How Chronic Pain Changes the Brain >>

​What is CRPS?

Complex regional pain syndrome is an umbrella term for pain and inflammation in a limb or other body parts that usually follows an injury, medical procedure or medical event like a heart attack or stroke. Often the pain is more serious than the injury that causes it.

There are four subtypes of CRPS:

• CRPS-1 happens after an injury or illness with no known nerve damage
• CRPS-2 happens after known damage to a specific nerve
• Warm CRPS is — you guessed it — a warm temperature sensation, usually along with redness and swelling, that happens usually early on
• Cold CRPS is when the affected limb is clammy and cooler than the other one, which is more common in long-term CRPS

CRPS can be short-term or chronic (lasting three months or longer) and symptoms may be debilitating for some people.

​CRPS symptoms

CRPS symptoms vary from person to person but the condition usually causes severe burning in the affected area. The pain can be constant, sporadic or get more intense when touched.

Symptoms of CRPS may change over time and can include:

• Swelling below the injury
• Changes in skin color (blue, red, purple, pale or blotchy skin)
• Changes in skin texture (shiny and thin or scaly and thick)
• Change in temperature of the skin
• Burning or “pins and needles” sensation
• Increased skin sensitivity (allodynia)
• Hair and nails that grow quickly or not all
• Excess sweating or no sweating at all in the affected area
• Joint stiffness
• Excessive bone growth or thinning of bones/bone loss
• Stiffness and decreased movement of the affected area

​CRPS risk factors

Research is ongoing as to why some people get CRPS and other people don’t even when experiencing the same injury. We do know the condition affects more women and people with a family history of CRPS may be more likely to develop the condition at an early age.

You may be at risk for CRPS if you:

• Have had an upper or lower limb injury (even if minor)
• Have had a work injury in a demanding physical occupation
• Have had severe trauma
• Experience allodynia or other sensory changes
• Smoke
• Have poor circulation
• Have diabetes
• Have an autoimmune disease
• Have had prior nerve damage

Certain experiences can also increase risk and can lead to CRPS. These can include:

• Having a fracture — especially a wrist fracture
• Wearing a cast
• Undergoing surgery
• Suffering a sprain or strains
• Experiencing nerve trauma
• Getting a cut or burn

​CRPS treatment

Although there’s no cure for CRPS, there are treatment options that may help with symptoms and recovery depending on the severity of symptoms.

Treatments for CRPS can include:

• Physical therapy
• Lifestyle changes like compression socks or sleeves
• Medications
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Prescription drugs
  • Creams or patches for local pain
  • Corticosteroids for inflammation and swelling
  • Spinal (intrathecal) medication
  • Ketamine therapy
• Spinal cord stimulation and other types of stimulation

Read: Tech Solutions for Chronic Pain >>

​CRPS life expectancy

Although CRPS is not life-threatening, the condition can be severe and have a significant impact on your quality of life. One review found that as many as 9 out of 10 people with CRPS experienced pain and motor dysfunction for more than a year, which led to physical, social and workplace problems.

If you’re living with CRPS, talk to your healthcare provider about treatment options that may help manage symptoms and put you on the path to more pain-free days.