Complex regional pain syndrome, referred to as CRPS, is a condition that isn’t well understood and is often difficult to diagnose.
Its main feature is a burning, persistent, severe, and debilitating pain in one of your limbs, which won’t go away. Apart from the burning, there’s usually a stabbing or stinging sensation. As well, there may be tingling and numbness. Sometimes it’s referred to as reflex sympathetic dystrophy (RSD).
Though pain is generally confined to one limb, it can sometimes spread to other parts of the body. Swelling or stiffness can occur with affected body parts, and persons can undergo fluctuating changes in colour or temperature. Many cases of CRPS gradually improve to some degree over time, or get completely better. However, other cases may never go away, and the affected person will experience pain for many years.
Flares, which are periods of pain lasting a few days or weeks, occur, and can be as a result of stress. Your skin in the affected area can become very sensitive, and even the slightest touch, bump, or change in temperature, can provoke intense pain.
In addition to chronic pain, CRPS can also cause a range of other symptoms, including:
• Strange sensations in the affected limb – it may feel as if the affected limb does not belong to the rest of your body, or it may feel bigger or smaller than the opposite, unaffected limb
• Alternating changes to your skin – sometimes your skin may be hot, red and dry, whereas other times it may be cold, blue and sweaty
• Hair and nail changes – your hair and nails may grow unusually slowly or quickly, and your nails may become brittle or grooved
• Joint stiffness andedema (swelling)
• Tremors and muscle spasms
• Difficulty moving the affected body part
• Difficulty sleeping
• Small patches of fragile bones (osteoporosis) in the affected limb.
Some of these problems can make it very difficult for people with CRPS to move around or travel easily.
What causes it?
The cause of CRPS is unknown, but it’s generally thought to be the result of the body reacting abnormally to an injury. It used to be thought that CRPS was a psychosomatic condition (symptoms all in the mind), but research has since disproved this.
There is no single test for complex regional pain syndrome. But it is usually diagnosed by ruling out other conditions that have similar symptoms. As a result, it can take a long time for a confident diagnosis of CRPS to be made. It’s estimated that the average length of time between the start of symptoms and a diagnosis is up to two years.
Some of the tests you may have to undergo to determine whether other conditions exist can include:
• Blood tests – to assess if there is an underlying infection or rheumatoid arthritis
• A magnetic resonance imaging (MRI) scan – to evaluate if there are issues with your tissues or bones
• An X-ray – to rule out problems with the joints and bones
• Nerve conduction studies – to assess damage to nerves.
A physical examination may also be carried out by your GP to check for physical signs of CRPS, such as swelling and changes to your skin’s temperature and appearance. A diagnosis of CRPS can usually be made if you have clear symptoms of the condition, and no other possible cause can be found.
Who is affected?
It’s difficult to estimate exactly how common CRPS is, as many cases may go undiagnosed or misdiagnosed. The ailment can begin at any age, including in children, although the average age for symptoms to start is around 50. Women make up around three out of every four cases.
Treatment for CRPS involves four main aspects
• Education and self-management – being given clear information about your condition and advice on any steps you can take to help manage your condition yourself
• Physical rehabilitation – therapy to help manage your symptoms, and reduce the risk of long-term physical problems, such as physiotherapy exercises
• Pain relief – the use of anticonvulsants or antidepressants to help reduce your pain
• Psychological support – interventions to help you cope with the emotional impact of living with CRPS, such as cognitive behavioural therapy (CBT)
Due to the complex nature of CRPS, a number of different professionals will usually be involved in a person’s care.
Your feet mirror your general health . . . cherish them!
Leana Huntley is an English trained foot health practitioner
attached to ALMAWI Limited
The Holistic Clinic. Contact the clinic at firstname.lastname@example.org or visit the website at www.almawiclinic.com.