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February 10, 2012
The Cleveland Clinic


Pain Management: Complex Regional Pain Syndrome

Introduction to Complex regional pain syndrome (CRPS)

Complex regional pain syndrome (CRPS), also called reflex sympathetic dystrophy syndrome, is a chronic pain condition in which high levels of nerve impulses are sent to an affected site. Experts believe that CRPS occurs as a result of dysfunction in the central or peripheral nervous systems.

CRPS is most common in people aged 20-35. The syndrome also can occur in children; it affects women more often than men.

There is no cure for CRPS.

What Causes Complex Regional Pain Syndrome?

CRPS most likely does not have a single cause but rather results from multiple causes that produce similar symptoms. Some theories suggest that pain receptors in the affected part of the body become responsive to catecholamines, a group of nervous system messengers. In cases of injury-related CRPS, the syndrome may be caused by a triggering of the immune response which may lead to the inflammatory symptoms of redness, warmth, and swelling in the affected area. For this reason, it is believed that CRPS may represent a disruption of the healing process.

What Are the Symptoms of Complex Regional Pain Syndrome?

The symptoms of CRPS vary in their severity and length. One symptom of CRPS is continuous, intense pain that gets worse rather than better over time. If CRPS occurs after an injury, it may seem out of proportion to the severity of the injury. Even in cases involving an injury only to a finger or toe, pain can spread to include the entire arm or leg. In some cases, pain can even travel to the opposite extremity. Other symptoms of CRPS include:

  • "Burning" pain
  • Swelling and stiffness in affected joints
  • Motor disability, with decreased ability to move the affected body part
  • Changes in nail and hair growth patterns. There may be rapid hair growth or no hair growth.
  • Skin changes. CRPS involves changes in skin temperature -- skin on one extremity can feel warmer or cooler compared to the opposite extremity. Skin color changes also are apparent as the skin is often blotchy, pale, purple or red. The texture of skin also can change, becoming shiny and thin. People with syndrome may have skin that sometimes is excessively sweaty.
  • CRPS may be heightened by emotional stress.



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Suggested Reading on Complex Regional Pain Syndrome by Our Doctors

  • Related Diseases & Conditions

    • Pain Management
      • Pain management and treatment can be simple or complex, according to its cause. There are two basic types of pain, nociceptive pain and neuropathic pain. Some causes of neuropathic pain includes: complex regional pain syndrome, interstitial cystitis, and irritable bowel syndrome. There are a variety of methods to treat chronic pain, which are dependant on the type of pain experienced.
    • Reflex Sympathetic Dystrophy Syndrome
      • Reflex sympathetic dystrophy syndrome (RSD) is a condition that features atypical symptoms including pain (often "burning" type), tenderness, and swelling of an extremity associated with varying degrees of sweating, warmth and/or coolness, flushing, discoloration, and shiny skin. RSD is also referred to as "the shoulder-hand syndrome." Treatment response is greater in earlier stages than later stages.
    • Chronic Pain
      • Chronic pain is pain (an unpleasant sense of discomfort) that persists or progresses over a long period of time. In contrast to acute pain that arises suddenly in response to a specific injury and is usually treatable, chronic pain persists over time and is often resistant to medical treatments.
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Complex Regional Pain Syndrome

Reflex sympathetic dystrophy (RSD) facts

  • Reflex sympathetic dystrophy (RSD) is characterized by a group of symptoms including pain (often "burning" type), tenderness, and swelling of an extremity associated with varying degrees of sweating, warmth and/or coolness, flushing, discoloration, and shiny skin.
  • How RSD occurs is not known, but there are often triggering events.
  • Symptoms of RSD often occur in three stages: 1) acute, 2) dystrophic, and 3) atrophic.
  • Diagnosis of RSD is based on clinical findings, supported by radiological tests.
  • Treatment of RSD is most effective in the earlier stages.

What is reflex sympathetic dystrophy (RSD)?

Reflex sympathetic dystrophy (RSD) is a condition that features a group of typical symptoms, including pain (often "burning" type), tenderness, and swelling of an extremity associated with varying de...

Read the Reflex Sympathetic Dystrophy Syndrome article »






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