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Complex regional pain syndrome

Contents of this page:

Alternative Names   

CRPS; RSDS; Causalgia - RSD; Shoulder-hand syndrome; Reflex sympathetic dystrophy syndrome; Sudeck's atrophy

Definition    Return to top

Complex regional pain syndrome (CRPS) is a chronic pain condition that mainly affects the arms and legs.

Causes    Return to top

Complex regional pain syndrome (CRPS) has two forms:

The cause of CRPS is not completely understood. It is thought to result from damage to the nervous system, including the nerves that control the blood vessels and sweat glands.

The damaged nerves are no longer able to properly control blood flow, feeling (sensation), and temperature to the affected area. This leads to medical problems in the:

Possible causes of CRPS:

The condition can sometimes appear without obvious injury to the affected limb.

This condition is more common in people ages 40-60, but it has been seen in younger people too.

Symptoms    Return to top

In most cases CRPS has three stages. Often, however, CRPS does not follow this pattern. Some people go into the later stages almost right away. Others stay in the first stage.

Stage 1 (lasts 1-3 months):

Stage 2 (lasts 3-6 months):

Stage 3 (irreversible changes can be seen)

Depression or mood changes may occur with these symptoms, especially in stage 3.

Exams and Tests    Return to top

Diagnosing CRPS can be difficult, but early diagnosis is very important. Often, the symptoms are severe compared to the original injury.

The doctor will take a medical history and do a physical examination. Other tests may include:

Treatment    Return to top

Treatment should be started as early as possible. This may prevent the disease from getting worse. Treatment usually includes a combination of therapies, such as:

Outlook (Prognosis)    Return to top

The outlook is better with an early diagnosis. If the doctor diagnoses the condition within the first stage, sometimes signs of the disease may disappear (remission) and normal movement is possible.

If the condition is not diagnosed quickly, changes to the bone and muscle may get worse and may not be reversible.

Possible Complications    Return to top

Complications can also occur with some of the nerve and surgical treatments.

When to Contact a Medical Professional    Return to top

Contact your health care provider if you develop constant, burning pain in an arm, leg, hand, or foot.

Prevention    Return to top

There is no known prevention at this time. Early treatment is the key to slowing the progression of the disease.

References    Return to top

Teadsdall RD, Smith BP, Koman AL. Complex regional pain syndrome (reflex synthetic dystrophy). Clinics in Sports Medicine. 2004;23:1.

Goetz CG. Goetz: Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa: Saunders; 2007.

Update Date: 2/13/2008

Updated by: Luc Jasmin, MD, PhD, Departments of Anatomy & Neurological Surgery, University of California, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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