Complex regional pain syndrome (patient information): Difference between revisions
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==Overview== | ==Overview== | ||
Complex regional pain syndrome (CRPS) is a chronic pain condition that can affect any area of the body, but often affects an arm or a leg. | Complex regional pain syndrome (CRPS) is a chronic [[pain]] condition that can affect any area of the body, but often affects an arm or a [[leg]]. | ||
==What are the symptoms of Complex regional pain syndrome?== | ==What are the symptoms of Complex regional pain syndrome?== | ||
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* Changes in skin temperature, switching between warm or cold | * Changes in skin temperature, switching between warm or cold | ||
* Faster growth of | * Faster growth of [[nail]]s and [[hair]] | ||
* Muscle | * [[Muscle spasm]]s and [[joint pain]] | ||
* Severe burning, aching pain that worsens with the slightest touch or breeze | * Severe burning, aching pain that worsens with the slightest touch or breeze | ||
* Skin that slowly becomes blotchy, purple, pale, or red; thin and shiny; swollen; more sweaty | * Skin that slowly becomes blotchy, purple, pale, or red; thin and shiny; swollen; more sweaty | ||
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''Stage 2 (lasts 3 - 6 months):'' | ''Stage 2 (lasts 3 - 6 months):'' | ||
* Continued changes in the skin | * Continued changes in the [[skin]] | ||
* Nails that are cracked and break more easily | * Nails that are cracked and break more easily | ||
* Pain that is becoming worse | * Pain that is becoming worse | ||
* Slower hair growth | * Slower hair growth | ||
* Stiff joints and weak | * Stiff joints and weak [[muscle]]s | ||
''Stage 3 (irreversible changes can be seen)'' | ''Stage 3 (irreversible changes can be seen)'' | ||
* Limited movement in limb because of tightened muscles and | * Limited movement in limb because of tightened muscles and [[tendon]]s ([[contracture]]) | ||
* Muscle wasting | * Muscle wasting | ||
* Pain in the entire limb | * Pain in the entire limb | ||
If pain and other symptoms are severe or long-lasting, many people may experience depression or anxiety. | If pain and other symptoms are severe or long-lasting, many people may experience [[depression]] or [[anxiety]]. | ||
==What causes Complex regional pain syndrome?== | ==What causes Complex regional pain syndrome?== | ||
Doctors aren't sure what causes CRPS. In some cases, the sympathetic nervous system plays an important role in the pain. Another theory is that CRPS is caused by a triggering of the immune response, which leads to the inflammatory symptoms of redness, warmth, and swelling in the affected area. | Doctors aren't sure what causes CRPS. In some cases, the [[sympathetic nervous system]] plays an important role in the pain. Another theory is that CRPS is caused by a triggering of the immune response, which leads to the inflammatory symptoms of [[redness]], warmth, and [[swelling]] in the affected area. | ||
CRPS has two forms: | CRPS has two forms: | ||
* CRPS 1 is a chronic nerve disorder that occurs most often in the arms or legs after a minor injury. | * CRPS 1 is a chronic nerve disorder that occurs most often in the arms or legs after a minor injury. | ||
* CRPS 2 is caused by an injury to the nerve. | * CRPS 2 is caused by an [[injury]] to the [[nerve]]. | ||
CRPS is thought to result from damage to the nervous system, including the nerves that control the blood vessels and sweat glands. | CRPS is thought to result from damage to the [[nervous system]], including the nerves that control the blood vessels and sweat glands. | ||
The damaged nerves are no longer able to properly control blood flow, feeling (sensation), and temperature to the affected area. This leads to medical problems in the: | The damaged nerves are no longer able to properly control blood flow, feeling (sensation), and temperature to the affected area. This leads to medical problems in the: | ||
* Blood | * [[Blood vessel]]s | ||
* | * [[Bone]]s | ||
* | * [[Muscle]]s | ||
* | * [[Nerve]]s | ||
* Skin | * [[Skin]] | ||
Possible causes of CRPS: | Possible causes of CRPS: | ||
* Injury directly to a nerve | * Injury directly to a [[nerve]] | ||
* Injury or infection in an arm or leg | * Injury or infection in an arm or leg | ||
Rarely, sudden illnesses such as a heart attack or stroke can cause CSPS. The condition can sometimes appear without obvious injury to the affected limb. | Rarely, sudden illnesses such as a [[heart attack]] or [[stroke]] can cause CSPS. The condition can sometimes appear without obvious injury to the affected limb. | ||
==Who is at highest risk?== | ==Who is at highest risk?== | ||
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* A test to show temperature changes and lack of blood supply in the affected limb (thermography) | * A test to show temperature changes and lack of blood supply in the affected limb (thermography) | ||
* Bone | * [[Bone scan]]s | ||
* Nerve conduction studies | * [[Nerve conduction studies]] | ||
* X- | * [[X-ray]]s | ||
==When to seek urgent medical care?== | ==When to seek urgent medical care?== | ||
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There is no cure for CRPS, but the disease can be slowed. The main focus is on relieving the symptoms and helping people with this syndrome live as normal a life as possible. | There is no cure for CRPS, but the disease can be slowed. The main focus is on relieving the symptoms and helping people with this syndrome live as normal a life as possible. | ||
Physical and occupational therapy should be started as early as possible. Starting an exercise program and learning to keep | Physical and occupational therapy should be started as early as possible. Starting an exercise program and learning to keep [[joint]]s and [[muscle]]s moving may prevent the disease from getting worse and help you perform everyday activities. | ||
Medications may be used, including pain medicines, steroids, certain blood pressure medicines, bone loss medications (such as | Medications may be used, including pain medicines, steroids, certain blood pressure medicines, bone loss medications (such as [[bisphosphonate]]s like Fosamax and Actonel), and [[antidepressant]]s. | ||
Some type of talk therapy, such as cognitive behavioral therapy or psychotherapy, can help teach the skills you need to live with chronic pain. | Some type of talk therapy, such as [[cognitive behavioral therapy]] or [[psychotherapy]], can help teach the skills you need to live with chronic pain. | ||
Surgical or invasive techniques that may be tried: | Surgical or invasive techniques that may be tried: | ||
* Injected medicine that numbs the affected | * Injected medicine that numbs the affected [[nerve]]s or pain fibers around the spinal column ([[nerve block]]) | ||
* Internal pain pump that directly delivers | * Internal [[pain]] pump that directly delivers [[medication]]s to the [[spinal cord]] (intrathecal drug pump) | ||
* Spinal cord stimulator, which involves placing electrodes (electrical leads) next to the spinal cord. A low-level electrical current is used to create a pleasant or tingling sensation in the painful area, which may help distract from the pain. | * Spinal cord stimulator, which involves placing electrodes (electrical leads) next to the spinal cord. A low-level electrical current is used to create a pleasant or tingling sensation in the painful area, which may help distract from the pain. | ||
* Surgery that cuts the | * Surgery that cuts the [[nerve]]s to destroy the pain (surgical [[sympathectomy]]), although it is unclear how many patients this helps. It may also make some patients' symptoms worse. | ||
==Where to find medical care for Complex regional pain syndrome?== | ==Where to find medical care for Complex regional pain syndrome?== | ||
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==Possible complications== | ==Possible complications== | ||
* Loss of muscle size or strength in the affected limb | * Loss of [[muscle]] size or strength in the affected limb | ||
* Spread of the disease to another part of the body | * Spread of the disease to another part of the body | ||
* Worsening of the affected limb | * Worsening of the affected limb | ||
Complications can also occur with some of the nerve and surgical treatments. | Complications can also occur with some of the [[nerve]] and surgical treatments. | ||
==Prevention of Complex regional pain syndrome== | ==Prevention of Complex regional pain syndrome== | ||
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==Sources== | ==Sources== | ||
http://www.nlm.nih.gov/medlineplus/ency/article/007184.htm | http://www.nlm.nih.gov/medlineplus/ency/article/007184.htm | ||
{{WH}} | |||
{{WS}} | |||
[[Category: | [[Category:Patient information]] | ||
[[Category:Neurology]] | |||
[[Category:Orthopedics]] | [[Category:Orthopedics]] | ||
[[Category: | [[Category:Rheumatology]] | ||
[[Category: | [[Category:Disease]] | ||
Latest revision as of 21:02, 29 July 2020
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Complex regional pain syndrome |
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Where to find medical care for Complex regional pain syndrome? |
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Complex regional pain syndrome On the Web |
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Directions to Hospitals Treating Complex regional pain syndrome |
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Risk calculators and risk factors for Complex regional pain syndrome |
For the WikiDoc page for this topic, click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Complex regional pain syndrome (CRPS) is a chronic pain condition that can affect any area of the body, but often affects an arm or a leg.
What are the symptoms of Complex regional pain syndrome?
The key symptom is pain that:
- Is intense and burning, and is much stronger than would be expected for the type of injury that occurred
- Gets worse, rather than better over time
- Begins at the point of injury, but often spreads to the whole limb, or to the arm or leg on the opposite side of the body
In most cases, CRPS has three stages. However, CRPS does not always follow this pattern. Some people develop severe symptoms almost right away. Others stay in the first stage.
Stage 1 (lasts 1 - 3 months):
- Changes in skin temperature, switching between warm or cold
- Faster growth of nails and hair
- Muscle spasms and joint pain
- Severe burning, aching pain that worsens with the slightest touch or breeze
- Skin that slowly becomes blotchy, purple, pale, or red; thin and shiny; swollen; more sweaty
Stage 2 (lasts 3 - 6 months):
- Continued changes in the skin
- Nails that are cracked and break more easily
- Pain that is becoming worse
- Slower hair growth
- Stiff joints and weak muscles
Stage 3 (irreversible changes can be seen)
- Limited movement in limb because of tightened muscles and tendons (contracture)
- Muscle wasting
- Pain in the entire limb
If pain and other symptoms are severe or long-lasting, many people may experience depression or anxiety.
What causes Complex regional pain syndrome?
Doctors aren't sure what causes CRPS. In some cases, the sympathetic nervous system plays an important role in the pain. Another theory is that CRPS is caused by a triggering of the immune response, which leads to the inflammatory symptoms of redness, warmth, and swelling in the affected area.
CRPS has two forms:
- CRPS 1 is a chronic nerve disorder that occurs most often in the arms or legs after a minor injury.
- CRPS 2 is caused by an injury to the nerve.
CRPS is thought to result from damage to the nervous system, including the nerves that control the blood vessels and sweat glands.
The damaged nerves are no longer able to properly control blood flow, feeling (sensation), and temperature to the affected area. This leads to medical problems in the:
Possible causes of CRPS:
- Injury directly to a nerve
- Injury or infection in an arm or leg
Rarely, sudden illnesses such as a heart attack or stroke can cause CSPS. The condition can sometimes appear without obvious injury to the affected limb.
Who is at highest risk?
This condition is more common in people ages 40 - 60, but it has been seen in younger people too.
When to seek urgent medical care?
Contact your health care provider if you develop constant, burning pain in an arm, leg, hand, or foot.
Diagnosis
Diagnosing CRPS can be difficult, but early diagnosis is very important.
The doctor will take a medical history and do a physical examination. Other tests may include:
- A test to show temperature changes and lack of blood supply in the affected limb (thermography)
- Bone scans
- Nerve conduction studies
- X-rays
When to seek urgent medical care?
Contact your health care provider if you develop constant, burning pain in an arm, leg, hand, or foot.
Treatment options
There is no cure for CRPS, but the disease can be slowed. The main focus is on relieving the symptoms and helping people with this syndrome live as normal a life as possible.
Physical and occupational therapy should be started as early as possible. Starting an exercise program and learning to keep joints and muscles moving may prevent the disease from getting worse and help you perform everyday activities.
Medications may be used, including pain medicines, steroids, certain blood pressure medicines, bone loss medications (such as bisphosphonates like Fosamax and Actonel), and antidepressants.
Some type of talk therapy, such as cognitive behavioral therapy or psychotherapy, can help teach the skills you need to live with chronic pain.
Surgical or invasive techniques that may be tried:
- Injected medicine that numbs the affected nerves or pain fibers around the spinal column (nerve block)
- Internal pain pump that directly delivers medications to the spinal cord (intrathecal drug pump)
- Spinal cord stimulator, which involves placing electrodes (electrical leads) next to the spinal cord. A low-level electrical current is used to create a pleasant or tingling sensation in the painful area, which may help distract from the pain.
- Surgery that cuts the nerves to destroy the pain (surgical sympathectomy), although it is unclear how many patients this helps. It may also make some patients' symptoms worse.
Where to find medical care for Complex regional pain syndrome?
Directions to Hospitals Treating Complex regional pain syndrome
What to expect (Outlook/Prognosis)?
The outlook is better with an early diagnosis. If the doctor diagnoses the condition within the first stage, sometimes signs of the disease may disappear (remission) and normal movement is possible.
If the condition is not diagnosed quickly, changes to the bone and muscle may get worse and may not be reversible.
In some people, symptoms go away on their own. In other people, even with treatment the pain continues and the condition causes crippling, irreversible changes.
Possible complications
- Loss of muscle size or strength in the affected limb
- Spread of the disease to another part of the body
- Worsening of the affected limb
Complications can also occur with some of the nerve and surgical treatments.
Prevention of Complex regional pain syndrome
There is no known prevention at this time. Early treatment is the key to slowing the progression of the disease.
Sources
http://www.nlm.nih.gov/medlineplus/ency/article/007184.htm Template:WH Template:WS