Complex Regional Pain Syndrome (CRPS)
is a chronic pain condition usually affecting one of the limbs (arms, legs, hands, or feet). CRPS usually occurs after an injury or trauma to that particular limb. CRPS is believed to be caused by damage to, or malfunction of the nervous systems. CRPS is characterised by prolonged or excessive pain and mild or dramatic changes in skin color, temperature, and/or swelling in the affected area.
CRPS symptoms can vary in severity and time. Studies of the disease show that most cases are mild and individuals recover gradually with time. In the more severe cases, individuals may not recover and may experience long-term disability.
1. Latest News
Emerging treatments for CRPS include:
Intravenous immunoglobulin (IVIG). Researchers in Great Britain reported that low-dose IVIG reduced pain intensity in a small trial of 13 patients with CRPS for 6 to 30 months who did not respond well to other treatments. Those who received IVIG had a greater decrease in pain scores than those receiving saline during the following 14 days after infusion. A larger study involving individuals with acute-phase CRPS is planned.
Ketamine. Investigators are using low doses of ketamine—a strong anesthetic—given intravenously for several days to either reduce substantially or eliminate the chronic pain of CRPS. In certain clinical settings, ketamine has been shown to be useful in treating pain that does not respond well to other treatments.
Hyperbaric oxygen. Several studies have investigated the use of hyperbaric oxygen therapy for chronic pain. Individuals lie down in a tank containing pressurised air, which delivers more oxygen to the body’s organs and tissues. Although research is still experimental, some researchers report hyperbaric oxygen can reduce swelling and pain, and improve range of motion in individuals with CRPS. www.NIH.gov
2. Symptoms and Solutions
In CRPS multiple symptoms may occur, we have offered some solutions here for the main symptom of pain. Other symptoms include
changes in skin texture on the affected area; it may appear shiny and thin
abnormal sweating pattern in the affected area or surrounding areas
changes in nail and hair growth patterns
problems coordinating muscle movement, with decreased ability to move the affected body part, and
abnormal movement in the affected limb, most often fixed abnormal posture (called dystonia) but also tremors in or jerking of the affected limb.
Note: Always seek advice from a doctor before beginning any listed treatments. Treatments can affect everyone differently.
Analgesics for CRPS:
Such as paracetamol or aspirin work best for localised pain. For more serious pain there is codeine and tramadol. For very severe pain, prescription drugs are available from your doctor including morphine, oxycodone and pethidine.
NSAIDs for CRPS:
work by reducing inflammation. Diclofenac, ibuprofen and naproxen are good for moderate pain.
Anticonvulsants for CRPS:
such as carbamazepine and sodium valproate are drugs intended for chronic pain which decrease `electric impulses` and decrease our experience of pain. The dose needs to be built up gradually over time and initially you may experience side effects however most of these go away with time. As with any medication, discuss with your doctor.
Working with a trained practitioner can assist you to develop skills to calm anxiety and can also equip you with knowledge to find your next steps towards wellness. Please ensure that you find a practitioner who understands how to navigate the territory of complex chronic health conditions.
3. Diagnosis and Tests
Mindfulness for CRPS:
Mindfulness is a strategy that has many health benefits including controlling pain. Mindfulness is a set of skills for healing, intuition, insight, calmness, focus, resilience and hope that you can develop to counter the stresses that chronic illness brings. You can literally "train your mind to promote healing. Mindfulness has a positive flow on affect into every aspect of a person’s life. For more info click here.
Acupuncture and Hypnosis:
Are methods that have been proven to relieve pain in some individuals.
A natural painkiller that contains the same active ingredient as aspirin. Avoid if you have an aspirin sensitivity.
Helps to block inflammatory cytokines, and may give pain relief to some.
Contains similar properties to ibuprofen.
Can be used for localised joint or muscle pain. Use carefully and avoid broken skin as it can burn.
As with many chronic illnesses there is no specific test to diagnose CRPS. Your treating doctor may request tests to check skin temperature and blood flow to a particular area of the body. If significant differences are noted in the results between the affected limb and an unaffected limb, you may be diagnosed with CRPS. An MRI test can be useful in showing changes to the tissue of the affected limb.
Which medications or supportive therapies have helped your Complex Regional Pain Syndrome?
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