Complex Regional Pain Syndrome
Complex regional pain syndrome (CRPS) is an uncommon, chronic condition that usually affects your arm or leg. Rarely, complex regional pain syndrome can affect other parts of your body.
Complex regional pain syndrome is marked by intense burning or aching pain. You may also experience swelling, skin discoloration, altered temperature, abnormal sweating and hypersensitivity in the affected area.
The cause of complex regional pain syndrome isn’t clearly understood, though it often follows an illness or injury. Treatment for complex regional pain syndrome is most effective when started early. In such cases, dramatic improvement and even remission are possible.
CAUSES
Complex regional pain syndrome occurs in two types with similar signs and symptoms, but different causes:
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Type 1. Previously known as reflex sympathetic dystrophy syndrome, this type occurs after an illness or injury that didn’t directly damage the nerves in your affected limb. About 90 percent of people with complex regional pain syndrome have type 1.
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Type 2. Once referred to as causalgia, this type follows a distinct nerve injury.
Many cases of complex regional pain syndrome occur after a forceful trauma to an arm or a leg, such as a gunshot wound or shrapnel blast. Other major and minor traumas — such as surgery, heart attacks, infections, fractures and even sprained ankles — also can lead to complex regional pain syndrome. It’s not well understood why these injuries can trigger complex regional pain syndrome.
TREATMENTS AND MEDICATION
Dramatic improvement and even remission of complex regional pain syndrome is possible if treatment begins within a few months of your first symptoms. Often, a combination of various therapies is necessary. Your doctor will tailor your treatment based on your specific case. Treatment options include:
Medications
Doctors use various medications to treat the symptoms of complex regional pain syndrome. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Advil, Motrin, others) and naproxen sodium (Aleve), may ease pain and inflammation. In some cases, doctors may recommend prescription medications. For example, antidepressants, such as amitriptyline, and anticonvulsants, such as gabapentin (Neurontin), are used to treat pain that originates from a damaged nerve (neuropathic pain). Corticosteroids, such as prednisone, may reduce inflammation.
Your doctor may suggest bone-loss medications, such as alendronate (Fosamax) and calcitonin (Miacalcin). Opioid medications may be another option. Taken in appropriate doses, they may provide acceptable control of pain. However, they may not be appropriate if you have a history of substance abuse or lung disease.
Some pain medications, such as COX-2 inhibitors (Celebrex), may increase your risk of heart attack and stroke. It’s wise to discuss your individual risks with your doctor.