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Complex Regional Pain Syndrome Type 1

WHAT YOU SHOULD KNOW:

  • Complex regional pain syndrome (CRPS-1) is a painful condition that affects the arms, legs, hands, or feet. It is a chronic (long-lasting) condition. It may also be called reflex sympathetic dystrophy or algodystrophy. CRPS-1 almost always occurs after an injury to a limb. How bad the injury was does not affect how likely you are to get CRPS-1. The main symptom of CRPS-1 is pain that is stronger than the injury would seem to cause. Also, the pain continues after the initial injury heals. Other symptoms you may have in the injured limb include abnormal swelling, sweating, and changes in skin temperature. You may also have trouble moving the limb and doing your normal daily activities.
  • To diagnose CRPS-1, your caregiver will examine you and take a health history. You may also need x-rays, a bone scan, or magnetic resonance imaging. Treatment depends on your symptoms. It may include medicines, physical therapy, or nerve blocks. Some people will recover completely from CRPS-1 over time. Early treatment for CRPS-1 can help reduce your symptoms and help prevent damage to the injured limb. Treatment can improve the movement of your limb and decrease your pain. With treatment, you may be able to return to your normal daily activities, such as work or sports.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • Medicines used to treat CRPS-1 may cause tiredness, dizziness, headache, and confusion. They may also cause weight gain. Certain medicines may cause a fever, low blood pressure, or abnormal heartbeats. When taking opioid pain medicines, there is a risk of becoming addicted.
  • Risks of nerve blocks include bleeding, infection, dizziness, nausea (upset stomach), and nerve damage. Risks of SCS include pain, bruising, infection, and bleeding. Also, the SCS device may not work. Procedures or surgery to treat your CRPS-1 may not work or may need to be repeated. Surgery may cause nerve damage and pain. Even with treatment, your CRPS-1 may not get better or go away, or your symptoms may return.
  • If you do not get treatment, your symptoms, such as pain and swelling, may get worse. You may have increased muscle weakness, joint stiffness, and trouble moving the injured limb. These symptoms may cause problems with your daily function. With CRPS-1, you are at risk of becoming depressed (deeply sad). Talk with your caregiver if you have any questions or concerns about your condition, treatment, or care.

WHILE YOU ARE HERE:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  • An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  • Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

Medicines:

You may need any of the following medicines to treat your CRPS-1:

  • Pain medicines: Most pain medicines are taken by mouth. Others can be applied to the skin as a cream or gel or given through patches put on the skin. Ask your caregiver for information about these or other pain medicines you may be given:
    • Nonsteroidal anti-inflammatory medicine: This family of medicine is also called NSAIDs. Nonsteroidal anti-inflammatory medicine may help decrease pain and inflammation (swelling). This medicine can be bought with or without a doctor's order. This medicine can cause stomach bleeding or kidney problems in certain people. Always read the medicine label and follow the directions on it before using this medicine.
    • Opioids: This medicine is given to block pain signals from anywhere in your body. Pain is caused when pain signals from the body are sent to the brain. Opioids are also called narcotic pain medicines. Take this medicine exactly as directed by your caregiver.
  • Steroids: This medicine may be given to decrease inflammation.
  • Antidepressants: These medicines are used to treat depression (deep sadness). They may also help decrease your pain.
  • Anti-seizure medicines: These are used to treat seizures. They can also help relieve pain from CRPS-1.
  • Biophosphonates and calcitonin: These medicines help prevent bone damage which can help relieve pain.
  • Calcium channel blockers: These medicines may be given to help improve blood flow in your injured limb.

Treatment options:

Ask your caregiver for more information about the following treatments for CRPS-1:

  • Therapy: Therapy can decrease pain and improve movement. As a result, it can help reduce or prevent loss of limb function. The main types of therapy are:
    • Physical therapy: You may need to see a physical therapist to teach you special exercises. These exercises help improve movement and decrease pain. Physical therapy can also help improve strength and decrease your risk for loss of function.
    • Occupational therapy: Occupational therapy (OT) uses work, self-care, and play activities to help you function with an injury. An occupational therapist can help you learn to use your injured limb during your daily life. You and your therapist will plan a therapy program that is right for you.
  • Treatments to block pain signals: The following treatments help interrupt or block pain signals to decrease pain from CRPS-1:
    • Nerve blocks: During this treatment, medicine is injected into the body to block pain signals. This helps relieve pain in the injured limb. The medicine may be injected directly into the problem limb. Or, it may be sent into the body through a tube placed in the neck or the spine. Medicine may be put into an IV (intravenous) in the injured limb.
    • Transcutaneous electrical nerve stimulation: This treatment is also called TENS. During TENS, small pads connected to a power source are attached to the skin, often near the problem area. The power source sends mild electrical signals to the pads. The signals go into the skin and help ease pain in the problem area.
    • Spinal cord stimulation: This treatment is also called SCS. With SCS, a small device is placed in the spine during surgery. The device sends electrical pulses to a certain area of the spinal cord. SCS may give you long-term pain relief and help you function better. SCS may be used if other treatments have not worked to decrease your pain.
    • Sympathectomy: This procedure is done to damage the area of your nerve that is sending pain signals to your brain. The procedure can be done using surgery or by injecting chemicals into the problem nerve. It can also be done using radiofrequency by sending mild electrical signals to the problem nerve. The electrical signals damage the nerve. A sympathectomy is only done if other treatment options do not work.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of the Blausen Databases or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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