Reflex sympathetic dystrophy (RSD) and Complex regional pain syndrome (CRPS) are two names for essentiall the same condition. CPRS is the more current term being used to describe the condition. It is a chronic systemic disease that causes swelling and severe pain, along with other malformations in the skin, the condition worsens over time. Typically CRPS affects extremities first then spreads to other parts of the body. Upwards of 90% of patients experienced it spreading to other areas of the body. One third of patients report symptoms throughout their body.
There are two forms of CRPS, Type I, which had previously been called reflex sympathetic dystrophy (RSD), Sudeck’s atrophy, algoneurodystrophy, or reflex neurovascular dystrophy (RND), doesn’t have lesions. The vast majority of patients are diagnosed with this form of CRPS, Type 1 is the most often referred to Type II, which used to be called causalgia, is identified by obvious nerve damage. Type II CRPS is very painful and difficult to treat. Type II ranks 42 of 50 on the McGill pain scale while type 1 is not mentioned on the scale. With Type II nerve injury is typically the cause.
What are the symptoms of CRPS?
- Burning, stabbing, throbbing pain.
- Sensitivity to water, and vibration.
- Moving or touching the affected area is often unbearable.
- Muscle spasms.
- Profuse sweating.
- Fluctuating skin temperature and color (the skin may appear bright red or reddish violet).
- Weakened bones.
- Tenderness or stiffness in the joints.
- Restricted or painful movement.
How is CRPS diagnosed?
There is no specific test for CRPS, however by discussing your symptoms with your doctor and having an examination for the skin discoloration and other symptoms it is possible to diagnose the condition. X-ray and MRI may be used to examine the condition of the patients’ bones. massage, and contrast bath therapy.
How do you treat CRPS?
Treatment of the condition is often multidisciplinary, utilizing different treatments and drugs simultaneously. Some of these treatments include:
- Physical/occupational therapy intended to desensitize the body part, restore range of motion, and improve function; some patients must do this therapy under general anesthesia to tolerate the pain. In this case care must be taken to not injure the atrophied tissue of weakened bone.
- Use of a TENS unit (transcutaneous electrical nerve stimulation).
- Progressive weight bearing conditioning exercises.
- Tactile desensitization, also called hot/cold immersion therapy, the affected limb or if necessary, the entire body is immersed in ice cold water, then immediately after immersed in warm water.
Along with therapy treatment with certain drug are often helpful, these drugs include:
- GABA analogs (like gabapentin and pregabalin)
- Alpha- or beta-adrenergic-blocking compounds
- Opioid anagesics
- Butorphanol (during episodes of extreme pain)
- Local anesthetics, Nerve block injections
- Spinal stimnulator
- Intramuscular botox injections
- Topical treatments
Another treatment for CRPS is mirror box therapy. In this treatment a mirror is used to reflect the unaffected limb while the affected limb is being worked. This is supposed to create the illusion that the affected limb is “normal” and so cause the patient to not feel pain during therapy.
What are expectations when a patient gets treatment?
Many patients can experience a reduction in their pain levels using one or more of the available treatments. If RSD is treated within 2 years of onset, over 75% of patients obtain excellent results with pain management doctors in Boulder, Greely and Loveland at Colorado Clinic. Discussing your condition and symptoms with your doctor will help them determine which of the available treatments could be right for you.