What Is complex regional pain syndrome?
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Complex regional pain syndrome (CRPS), also known as Algodystrophy, is a lesser understood condition which causes severe chronic pain which can be very debilitating to the individual with the condition. It is characterized by joint pain affecting mainly the legs (foot, ankle and knee) and arms (hand, shoulder). It usually occurs after trauma, sprain or fracture, or surgery. Algodystrophy is a rare and debilitating bone disease. It can occur at any age but affects mostly adults between 35 and 65 years old and women in 3 out of 4 cases. It affects the upper limbs more often than the lower limbs.
There are two types of dystrophy. Type I stenosis is the most common form (90% of cases). It does not affect the nerves, unlike type II algodystrophy, whose prognosis is less favorable.
Causes Of CRPS
The causes of CRPS are still poorly understood. In the majority of cases, it is manifested as a result of bone or joint trauma: sprain, dislocation, fracture, orthopedic surgery etc. This causes a dysfunction of the nervous system. The peripheral nerves in charge of the contraction of the arteries and capillaries around the joints are disturbed. This then creates a lack of vascularization of the affected area, resulting in changes which cause pain. An infarction, stroke, Parkinson's disease, vascular disorders or simply high stress could also act as an aggravating factor of CRPS.
Symptoms Of CRPS
The primary symptom of CRPS is intense pain, which can be likened to a burning or stinging sensation, most often in the foot, legs, hand, or shoulders. Other symptoms also appear:
- stiff joints and swelling of the affected limbs (oedema)
- functional impotence (difficulty to move)
- hypersensitivity of the skin
- excessive sweating
- smooth and pale skin
- changes in nail and hair growth in the affected region (brittle nails, loss of hair)
- Muscle spasms
- Irregular sleeping pattern or insomnia
Spontaneous recovery is slow and will usually take several months. It is rare that the disease leaves lasting effects.
How CRPS is diagnosed
There is no single specific way CRPS is diagnosed and is usually determined by means of a process of elimination with regard to conditions that show similar symptoms as CRPS. Depending on the patient's symptoms, CRPS is usually diagnosed via:
- blood test
- X-ray
- MRI scan (magnetic resonance imaging)
- specified tests for nerve damage
Treatment For CRPS
Treatment for CRPS should be started as early as possible to effectively slow the progression of the disease. It aims to fight against pain and uses analgesics, nonsteroidal anti-inflammatory drugs and sometimes certain antidepressants. It is also important to perform rehabilitation to reduce joint disorders. Physiotherapy and balneotherapy are also important. Psychotherapy can be implemented too if the patient suffers from anxiety or depression.
