Carpal Tunnel

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Complex Regional Pain Syndrome Can Be A Debilitating Condition. Let Silver Spring Medical Center Help Get You Out Of Pain, Fast!

Complex regional pain syndrome (CRPS) formerly reflex sympathetic dystrophy (RSD), "causalgia", or reflex neurovascular dystrophy (RND) is an amplified musculoskeletal pain syndrome (AMPS). It is a chronic systemic disease characterized by severe pain, swelling, and changes in the skin. CRPS often worsens over time. It may initially affect an arm or leg and spread throughout the body; 35% of people report symptoms throughout their whole body.

The cause of CRPS is unknown though CRPS is associated with dysregulation of the central nervous system and autonomic nervous system resulting in multiple functional loss, impairment, and disability. Precipitating factors include injury and surgery, although there are documented cases where no injury had occurred at the original site. CRPS is not caused by psychological factors, yet the constant pain and reduced quality of life has been known to cause psychological problems (such as increased depression and anxiety). Although "research does not reveal support for specific personality or psychopathology predictors of the condition," CRPS is associated with psychosocial effects, including impaired social and occupational function. Treatment is complicated, involving medications, physical and occupational therapy, psychological treatments, and neuromodulation and is often unsatisfactory, especially if delayed.

Diagnosis

There is often spontaneous pain pain resulting from a stimulus which would not normally provoke pain, such as a light touch of the skin is not limited to the territory of a single peripheral nerve and is disproportionate to the inciting event.

Our Special Treatment

The general strategy in CRPS treatment is often multi-disciplinary, with the use of different types of medications combined with distinct physical therapies. We like to incorporate nerve blocks and therapy in close proximity to each other to afford the patient the best chance of improvement. This coordination of care is absolutely necessary! It allows the therapist to begin desensitizing the area while still under the effects of the nerve block.

Physical Therapy

Physical and occupational therapy are important components of the management of CRPS primarily by desensitising the affected body part, restoring motion, and improving function.

Prognosis

Good progress can be made in treating CRPS if treatment is begun early, ideally within three months of the first symptoms. If treatment is delayed, however, the disorder can quickly spread to the entire limb, and changes in bone, nerve, and muscle may become irreversible. The prognosis is not always good. Johns Hopkins Hospital reports that 77% of sufferers have spreads from the original site or flares in other parts of the body. The limb, or limbs, can experience muscle atrophy, loss of use, and functionally useless parameters that require amputation. RSD/CRPS will not "burn itself out", but if treated early, it is likely to go into remission.

The above information has been gathered from various journals and articles for general information purposes. Our Medical and Physical Therapy staff will review your specific case and history when you come in for an appointment!