CRPS | CRPS Help | CRPS Pain Management | Complex Regional Pain Syndrome
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What is Complex Regional Pain Syndrome?

A person with Complex Regional Pain Syndrome (CRPS) experiences chronic pain in addition to changes in blood flow, sweating, and swelling of the painful area. The condition can make it hard for a person to move the painful body part, and sometimes CRPS can lead to changes in tissues such as bones and skin.
CRPS can affect any part of the body, but arms and legs are usually involved. In some cases, many different parts of the body may be affected at once. The condition can be progressive. It can get worse in one area or spread to other areas of the body, or it may stay the same for a long time and even improve.
An injury usually causes CRPS to develop. When CRPS develops from an injury to the skin, bones, joints, or tissue, it is called reflex sympathetic dystrophy. If it develops due to an injury to major nerves it is called causalgia. An injury that leads to CRPS may not be major. It may be so minor that the patient does not even remember being injured.

Who Gets CRPS?

Not all injuries result in CRPS. Patients who have CRPS have probably suffered numerous other injuries that do not result in the condition. No one knows for certain why CRPS develops, but experts believe it may happen for a few different reasons:

  • The condition may run in a person’s family
  • Stress in the person’s life at the time of the injury may cause the condition
  • The injured body part is not used for a long time. This may occur if the person has a cast or if the person is not moving the injured body part normally

What Causes CRPS?

For some time doctors believed that CRPS always involved a problem with the sympathetic nervous system. The sympathetic nervous system controls the size of blood vessels, sweating, and other bodily functions. Doctors now believe that problems with the sympathetic nervous system is the cause of CRPS for only some patients. Pain caused by problems in the sympathetic nervous system is called sympathetically-maintained pain or SMP. A doctor can determine if a patient is suffering from SMP by doing a sympathetic nerve block. This involves injecting a localized anesthetic into different sites in the body. If a person suffering from CRPS experiences pain relief from a sympathetic block, then he or she has SMP.

SMP, however, does not explain the pain in the majority of patients with CRPS. Experts have concluded that patients with CRPS have problems in the peripheral nervous system and the central nervous system. Other factors such as emotional issues and stress can also contribute to the development of CRPS because they directly affect the activity of the nervous system, muscles, and bones.

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A doctor may make the diagnosis of CRPS during a physical exam. This diagnosis may be made based on how a patient describes the symptoms. The patient does not need a nerve block, x-rays, laboratory tests, or bone scans in order for a doctor to diagnose CRPS.

Symptoms that a doctor uses to diagnose CRPS include:

Pain that is constant or almost constant, with:

  • pain caused by things that do not usually cause pain, such as clothing, wind, cold or a light touch to the skin (called “allodynia”), and/or
  • severe pain when only a slight pain would be expected, such as when a doctor lightly pricks the skin with a pin (called “hyperalgesia”)
  • Depression or anxiety (common to all chronic pain disorders)

Having some of the following in the painful area:

  • Swelling
  • changes in skin color (mottled, purple-bluish, red)
  • skin temperature that is not normal (either hotter or colder than other areas)
either more or less sweating in the area

Other Symptoms

Other symptoms may include:

  • Problems moving the painful body part
  • Tremors (“shakes”)
  • Depression or anxiety (common to all chronic pain disorders)

Trophic Changes

Trophic changes are changes to the area where the pain occurs. These changes may include:

  • Wasting away of the skin, tissues, or muscle
  • Thinning of the bones
  • Changes in how the hair or nails grow, including thickening or thinning of hair or brittle nails

CRPS Specialists


Dr. Tamer Elbaz

New York, NY

Dr. Ronny Hertz

New York, NY

Dr. Robert Schwartzman

Philadelphia, PA

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