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Welcome, eCureMe.com medical contents search April 26, 2013
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CRPS


Complex regional pain syndrome, reflex sympathetic dystrophy, RSD, Causalgia, Shoulder-hand syndrome, or Sudeck's atrophy.

  • Complex regional pain syndrome (CRPS) is a chronic pain syndrome, usually involving one leg or arm.

  • The symptoms vary in severity and duration. The pain is usually localized to the injured arms or legs, but CRPS can affect any part of the body.

  • The main symptoms are a throbbing, burning pain coupled with a tingling sensation. This severe pain is often accompanied by extreme sensitivity to even the slightest touch in the affected areas of skin.
  • The symptoms of the acute stages (first 3 to 6 months) are characterized by swelling, tenderness, excessive sweating, heating sensation and a change in skin color (reddish, mottled) in the affected area. After an acute period, the skin becomes cool and bluish in some patients.
  • Other changes include a thickening of the skin tissue or a swelling and heating sensation. In later periods where there is joint stiffness coupled with contracture and a thinning of the skin, subcutaneous and muscle tissue can be seen. However, the course of disease is different from person to person.

  • The mechanism of pain is uncertain. CRPS develops after a wide variety of tissue injuries, including bone fractures, soft tissue trauma and Strokes. CRPS can also occur after minor injuries.


  • The diagnosis is based on the history of the injury, symptoms and signs.
  • Radiologic tests are supportive.
  • Simple X-Rays of affected area to detect the bone loss (osteoporosis) in the later stages.
  • Bone scans

  • There is no single treatment that cures CRPS.
  • The response of patients to therapy may vary
  • Corticosteroid (prednisone) -- short-term therapy with prednisone may result in the early remission of CRPS in some patients.
  • Drugs for pain control -- various drugs are used to relieve pain from CRPS, including anti-seizure medications, antidepressants and opioids.
  • Physical therapy relieves swelling and prevents contracture.
  • Sympathetic nerve blocks -- injection of local anesthetics to the sympathetic nerves in the neck (stellate ganglion) or lower back (lumbar sympathetic nerve blocks).
  • Lumbar sympathectomy -- destruction of sympathetic nerves to get longer pain relief than the nerve block.

  • Early treatment is most effective if started within 3 months from the onset.
  • About 50 to 60 % of CRPS patients have significant chronic pain for
    6 months.











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