Complex Regional Pain Syndrome (CRPS)/Reflex Sympathetic Dystrophy (RSD)

This is an uncommon, chronic condition that affects an arm or leg with intense burning, aching pain and swelling.  Changes in skin including texture and color as well as temperature may occur.  And this is one of those conditions that has the medical community baffled.  No one really knows why it happens.  It seems to be more common in women, but men can be affected and it can happen in any age group. 

Two types have been identified.  Type I was previously recognized as reflex sympathetic dystrophy or RSD and occurs after an illness or injury that did not directly damage the nerves in the affected limb.  This is the most common type.  Type II is caused by a direct, distinct nerve injury.  Examples of events that can trigger CRPS include gunshot wounds, infections, heart attacks, fractures, surgery and even a minor ankle sprain.

There are three stages of the syndrome, but not everyone will progress through the stages at the same rate:
Stage 1 lasts 1-3 months with severe pain in the affected limb, swelling, hypersensitivity to touch, dry or thinning skin.
Stage 2 lasts 3-6 months with more change to the skin including color and texture and the swelling tends to spread.  Stiff muscles or joints can also be seen.
Stage 3 includes limited movement in the limb and irreversible skin damage, atrophy of the affected muscles and contracture of the digits.

Diagnosis of CRPS starts with a review of your medical history and any events that may be related to the beginning of your pain.  A full examination of the affected area and xrays to evaluate bones and joints is the first step.  Bone scans, MRI and nerve conduction studies may also be ordered by your physician to help diagnosis this disorder.

Recovery from CRPS is possible if the diagnosis is made early and treatment begins within a few months of your initial symptoms. 

Treatment includes multiple different types of medications to reduce pain and swelling as well as control the neurologic responses occurring with the syndrome.  Physical therapy can also be used to improve range of motion and strength.  Injection therapy may also be useful.  Once the diagnosis is made a referral to a pain management specialist is often made.