Complex Regional Pain Syndrome

Complex Regional Pain Syndrome, CRPS, is a disease characterised by severe pain and abnormal changes to the skin of the area affected.  Rated higher on the McGill pain scale than both amputation and childbirth, CRPS often causes the skin to become increasingly sweaty, and this is often paired with abnormal hair and nail growth.  Chronic swelling/inflammation, increased sensitivity and altered blood flow to the area are also a frequent characteristic of the condition.

The causes of CRPS are still questioned, although it is considered to be an abnormal response to tissue injury.  This means a simple injury, for example fracturing a toe, can cause a cascade of problems, and what should have been resolved in around 3-4 months can affect an individual for 5+ years if left untreated.

There are multiple treatment possibilities for CRPS, some of which work better for some than others. There are a significant amount which are surgical or provided by anaesthetist, for example ketamine treatments, although physiotherapy has shown to be increasingly effective.

A therapy technique used in the early recognition of CRPS as a medical condition is mirror box therapy.  This is where a patient puts a limb into a hole in a box with two mirrors in the centre.  The patient will then put the opposite limb into another adjacent hole.  When viewed from each angle, the patient will see a reflection of each limb.  By moving the limb with which they are not experiencing any problems, they will see the reflection of this in the mirror and this will trick the brain into linking this movement with the problem limb.  This therapy has had varied results, and provides the best responses from individuals with skin changes, or where the affected limb is visually different from the unaffected side.

According to Arthritis Research UK, “Physiotherapy is probably the single most important treatment for CRPS.  The aim is to relieve pain and keep the affected limb mobile. This will help prevent stiffness and loss of muscle tone as well as promoting circulation. Exercise can be difficult if you have severe pain so you’ll need to work with your physiotherapist to find out which exercises work best for you, when you should stop and the techniques you can use to cope if your pain does increase for a time.”

Have you ever had treatment for CRPS or anything similar? Please share your experiences in the comments section below.