Complex regional pain syndrome

Alternative Names:
CRPS; RSDS; Causalgia; Shoulder-hand syndrome; Reflex sympathetic dystrophy syndrome; Sudeck's atrophy

Symptoms:

In most cases CRPS has 3 stages. Often, however, CRPS does not follow this progression. Some people go into the later stages almost immediately. Others remain in Stage 1 indefinitely.

Stage 1 (lasts 1-3 months)

  • Severe burning, aching pain increasing with the slightest touch or breeze
  • Swelling with warmth or coolness
  • Skin becomes dry and thin, changes color
  • Increased nail and hair growth
  • Pain may move further up or down the affected limb

Stage 2 (lasts 3-6 months)

  • Swelling spreads
  • Noticeable changes in skin texture and color
  • Decreased hair growth
  • Changes in bone seen in X-rays
  • Stiff muscles and joints

Stage 3 (irreversible changes become evident)

  • Pain may exist in the entire limb
  • Permanent tissue changes
  • Muscle wasting
  • Limited mobility in limb
  • Contractions involving muscles and tendons


Signs and tests:

Diagnosing CRPS can be difficult, but early diagnosis is very important. Often, the symptoms are severe compared to the original trauma or injury.

It is possible to make a diagnosis based on a medical history and physical examination. The key complaint is the severe, burning pain. Additional tests may include X-rays, bone scans, nerve conduction studies, and thermography (a test to show temperature changes and lack of blood supply in the painful area of the affected limb).




Review Date: 6/6/2002
Reviewed By: Alan Greene, MD, CMO, A.D.A.M.

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