Complex Regional Pain Syndrome
(CRPS; Reflex Sympathetic Dystrophy [RSD]; Causalgia; Sympathetically Maintained Pain)
Complex regional pain syndrome (CRPS) is lasting pain in one limb that happens after an injury.
Type 1 happens after a soft tissue or bone injury. It is the most common type. Type 2 happens after a nerve injury.
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CRPS may happen after:
How CRPS develops is not clear. One or more below may play a role:
This problem is more common in women, especially those of European descent. It is also more common in adults.
Other things that may raise the risk of this problem are:
- Prior surgery that involved long-term tourniquet use
- Certain genetic disorders
Symptoms mainly appear after an injury. The most common is long-term pain. It may be constant or severe. Pain is described as burning, throbbing, aching, squeezing, or shooting.
These may change over time and cause:
- Sensitivity to touch or even a light breeze
- Swelling in the arm or leg
- Sweating patterns that are not normal
- Very warm or cool skin
- Hair and nails that become brittle and crack
- Movements in the arm or leg such as a tremor, jerking, or spasms
- A pale, blue, or shiny look to the skin
- Poor joint movement
The doctor will ask about your symptoms and health history. A physical exam will be done. This may be enough to make the diagnosis.
Nerve tests may be done, such as:
Imaging tests usually are not needed unless there is a certain reason to have them.
The goal of treatment is to ease pain and improve function. Options are:
- Physical and occupational therapy to help with muscle strength, flexibility, and daily activities
- Medicine to help manage pain, swelling, and other symptoms
- Counseling to cope with pain and to help with depression, anxiety, and stress
- A nerve block to ease pain
- Implants that deliver electrical impulses to the spine to manage pain
- Surgery to destroy any nerves that are causing problems
There are no known guidelines to prevent CRPS.
International Research Foundation for RSD/CRPS
U.S. Pain Foundation
Bruehl S. Complex regional pain syndrome. BMJ. 2015 Jul 29;351:h2730.
Complex regional pain syndrome (CRPS). EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/complex-regional-pain-syndrome-crps. Accessed October 5, 2020.
Complex regional pain syndrome (CRPS). Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/neurologic-disorders/pain/complex-regional-pain-syndrome-crps. Accessed October 5, 2020.
Complex regional pain syndrome fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Complex-Regional-Pain-Syndrome-Fact-Sheet. Accessed October 5, 2020.
Last reviewed September 2020 by EBSCO Medical Review Board Rimas Lukas, MD Last Updated: 5/21/2021