Chronic Conditions
Complex Regional Pain Syndrome
A disproportionate pain response after injury, with skin, temperature and swelling changes in a limb.
What complex regional pain syndrome is
Complex regional pain syndrome (CRPS) develops after an injury, fracture or surgery when the nervous system's pain response fails to switch off. The affected limb may change color and temperature, swell, sweat abnormally, or become intensely sensitive to light touch.
CRPS is time-sensitive. Early sympathetic blocks combined with aggressive physical therapy give the best chance of interrupting the cycle, and spinal cord stimulation has well-documented benefit when earlier treatment is not enough.
Common symptoms
- Burning pain far out of proportion to the original injury
- Color, temperature or sweating changes in the limb
- Swelling, skin, hair or nail changes
- Extreme sensitivity to touch or movement
Common causes
- A fracture, sprain or crush injury to a limb
- Surgery on a hand, foot or limb
- Prolonged immobilization of a limb, such as in a cast
- Nerve injury during an otherwise minor procedure
- In some cases, no clearly identifiable triggering event
How it is diagnosed
CRPS is diagnosed clinically, based on a set of established criteria that look at pain out of proportion to the original injury together with changes in skin color, temperature, sweating, swelling or hair and nail growth in the affected limb.
There is no single blood test or scan that confirms CRPS, though a bone scan or thermography can sometimes support the diagnosis. Careful examination and comparison with the unaffected limb are central to making the diagnosis accurately and ruling out other explanations.
A diagnostic sympathetic nerve block, which temporarily numbs the sympathetic nerves supplying the limb, can both support the diagnosis and indicate whether sympathetic-targeted treatment is likely to help.
Treatment options we offer
Which of these applies depends on your examination and, where appropriate, a diagnostic block confirming the source of your complex regional pain syndrome.
- Nerve BlocksTargeted injections that interrupt pain signals along a specific nerve or nerve plexus.
- Spinal Cord StimulationAn implanted device that modulates pain signals before they reach the brain, trialed first so you know it works.
- Medication ManagementCareful, monitored use of the right medication class for your pain type, with clear goals and safety oversight.
- Intrathecal Pain PumpAn implanted pump delivering medication directly to the spinal fluid, achieving relief at a fraction of the oral dose.
When to see a specialist
- Pain in a limb that seems far more severe than the original injury would explain
- Visible changes in skin color, temperature or sweating in the affected limb
- Swelling, or changes in hair or nail growth, in the injured limb
- Extreme sensitivity to light touch or clothing on the limb
- Any of these symptoms appearing soon after an injury or surgery, since earlier treatment of CRPS gives the best chance of a good outcome
Common questions
How quickly should CRPS be treated after it starts?
Is CRPS permanent?
Why does physical therapy matter so much for CRPS?
Can CRPS spread to other limbs?
Related conditions
- ArthritisDegenerative and inflammatory joint disease of the spine, hips, knees and shoulders.
- NeuropathyNerve damage causing burning, numbness and tingling, most often in the feet, legs and hands.
- FibromyalgiaWidespread musculoskeletal pain with fatigue, sleep disturbance and heightened pain sensitivity.
- Cancer PainPain from tumor, treatment or nerve involvement, managed alongside the patient's oncology team.
Ready to get a real diagnosis?
Most patients are seen within two weeks. Call our office or send a request and our staff will help you choose the most convenient location.