Complex regional pain syndrome - Symptom
CRPS; RSDS; Causalgia - RSD; Shoulder-hand syndrome; Reflex sympathetic dystrophy syndrome; Sudeck's atrophy
The key symptom is pain that:
- Is intense and burning, and is much stronger than would be expected for the type of injury that occurred
- Gets worse, rather than better over time
- Begins at the point of injury, but often spreads to the whole limb, or to the arm or leg on the opposite side of the body
In most cases, CRPS has three stages. However, CRPS does not always follow this pattern. Some people develop severe symptoms almost right away. Others stay in the first stage.
Stage 1 (lasts 1 - 3 months):
- Changes in skin temperature, switching between warm or cold
- Faster growth of nails and hair
- Muscle spasms and joint pain
- Severe burning, aching pain that worsens with the slightest touch or breeze
- Skin that slowly becomes blotchy, purple, pale, or red; thin and shiny; swollen; more sweaty
Stage 2 (lasts 3 - 6 months):
- Continued changes in the skin
- Nails that are cracked and break more easily
- Pain that is becoming worse
- Slower hair growth
- Stiff joints and weak muscles
Stage 3 (irreversible changes can be seen)
- Limited movement in limb because of tightened muscles and tendons (contracture)
- Muscle wasting
- Pain in the entire limb
If pain and other symptoms are severe or long-lasting, many people may experience depression or anxiety.
Signs and tests:
Diagnosing CRPS can be difficult, but early diagnosis is very important.
The doctor will take a medical history and do a physical examination. Other tests may include:
- A test to show temperature changes and lack of blood supply in the affected limb (thermography)
- Bone scans
- Nerve conduction studies
- Reviewed last on: 3/9/2010
- Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
National Institute of Neurological Disorders and Stroke. Complex regional pain syndrome fact sheet. Updated December 21, 2009. Accessed January 19, 2010.
Saxton DL, Lindenfeld TN. Complications. In: DeLee JC, Drez D Jr., Miller MD, eds. DeLee and Drez's Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier;2009:chap 7.
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