Complex Regional Pain Syndrome
Complex regional pain syndrome is a debilitating condition that can be triggered by a minor injury to the arm or the leg. It involves a dysregulation of the pain sensory apparutus, and dysregulation of the sympathetic nervous system including the sensory and motor nerve pathways. The exact mechanism of CRPS is not clearly understood, but there are several postulated mechanisms including changes in the cortex of the brain, as well as changes to the nervous and vascular systems.
The incidence varies between 5-25 per 100,000 people. CRPS affects females 4x more than males. The upper limbs are more commonly affected than the lower limbs in adults, and the incidence increases in age until the age of 70. CRPS is mainly associated with sprains, fractures, elective surgery and limb immobilization.
Symptoms associated with CRPS include: - Sensory loss (numbness), or sensory gain (sharp, shooting, burning pain, hyperalgesia and/or allodynia) - Vasomotor changes (temperature changes, colour changes in the skin)
- Sudomotor changes (swelling changes, sweating changes)- Motor changes (decreased range of motion, weakness, tremor, dystonia)- Trophic changes (changes to hair, skin, nails)
CRPS is associated with a reduced quality of life. It can be significantly disabling and has a variable prognosis.
A careful and comprehensive assessment is required to identify the factors that can be addressed. This often requires a multidisciplinary approach including physiotherapy (desensitization therapy, mirror box therapy, graded motor imagery), clinical psychology, optimization of analgesia, and procedural interventions (ie. sympathetic block). Lignocaine and ketamine infusions may also be beneficial.
Helpful Resources: - Better Health Victoria: Complex regional pain syndrome fact sheet - Australian Prescriber: Complex regional pain syndrome information - Musculoskeletal Australia: Managing your pain - The Pain Toolkit
CRPS is associated with a reduced quality of life. It can be significantly disabling and has a variable prognosis.
A careful and comprehensive assessment is required to identify the factors that can be addressed. This often requires a multidisciplinary approach including physiotherapy (desensitization therapy, mirror box therapy, graded motor imagery), clinical psychology, optimization of analgesia, and procedural interventions (ie. sympathetic block). Lignocaine and ketamine infusions may also be beneficial.
Helpful Resources: - Better Health Victoria: Complex regional pain syndrome fact sheet - Australian Prescriber: Complex regional pain syndrome information - Musculoskeletal Australia: Managing your pain - The Pain Toolkit
DisclaimerThe above information is for general education only and is not intended as a substitute for your own independant health advice. At Western Pain clinic we comprehensively assess each patients pain condition and provide advice using the latest evidence-based treatments. If you would like to find out more information about complex regional pain syndrome, please discuss this with our doctor during your consultation.