What is Complex Regional Pain Syndrome?
Complex regional pain syndrome, is a chronic condition characterized by pain that continues for six months or longer. CRPS is not common, but when it happens, it’s best to start treatment immediately. The condition affects mainly the arms, legs, hands, and feet. However, when left untreated, pain can spread to the entire body.
CRPS is defined by continuous, intense pain that worsens over time. Pain spreads from one localized area to an entire affected area, such as from the foot up to the entire leg. Over time, skin in the affected area also begins to change, becoming overly-sensitive and sweating excessively. Likewise, affected skin color can change, becoming mottled, red, blue, or extremely pale.
Symptoms of Complex Regional Pain Syndrome
Intense pain is the most common symptom of complex regional pain syndrome, with a reported 80 to 90% of CRPS patients having limb pain as a symptom. Unlike many chronic pain conditions, symptoms can be both felt and seen in the arms, legs, feet, and hands.
Symptoms of CRPS include:
- Constant burning or throbbing pain
- Joint stiffness or swelling
- Muscle spasms or weakness
- Sensitivity to touch or cold
- Changes in skin temperature between sweating and cold
- Sweating only on the affected limb
- Skin that becomes white, mottled, red, or blue
- Skin that turns thin or shiny
- Nails or hair growing faster than normal
Symptoms of CRPS Spreading
For most patients, complex regional pain syndrome goes through three stages. With each stage, signs and symptoms get more severe. Early in the course of CRPS, symptoms can gradually increase in the order of:
- First Three Months: A patient experiences burning pain, and the affected area is irregularly sensitive to touch. Swelling and joint stiffness begin.
- Three Months to One Year: Swelling is more long-lasting, and joints become stiffer. Pain spreads and any pre-existing wrinkles in the area begin to disappear.
- One Year or More: Skin becomes pale, shiny, and stretched looking. Pain may lessen but stiffness will worsen. There is a heightened likelihood that the affected limb will suffer a permanent restriction of motion.
What is the Cause of CRPS?
Most doctors agree that the cause of complex regional pain syndrome is rooted in damage to the nervous system, however, the exact cause of the condition is unknown. The most commonly accepted cause of CRPS is believed to be damage to, or the malfunction of, the central and peripheral nervous system. The peripheral nervous system involves nerves signaling from the brain and spinal cord to the rest of the body; the central nervous system is composed of the brain and spinal cord.
Complex regional pain syndrome may be the result of over-stimulation of the body’s fight or flight response, initiated by an injury to the peripheral system. In fact, in more than 90 percent of cases, CRPS is triggered by a clear history of trauma or injury. Over-stimulation of the peripheral nervous system can create excessive inflammation, leading to that “on-fire” feeling beneath the skin and leading to changes in skin texture and color.
CRPS has a variety of triggers, most commonly:
- Fractures
- Limb immobilization (such as being in a cast)
- Sprains and strains
- Burns, cuts, and bruises
- Surgery
- Infection
- Heart attack
- Stroke
- Cancer
Much like a food allergy, some people respond excessively to a trigger that causes no problem for others. Doctors believe that in patients with CRPS, the body is experiencing an abnormal response that magnifies the effects of an injury.
Classifications of Complex Regional Pain Syndrome
In patients with complex regional pain syndrome, something went wrong during the healing process from the original injury that leads the nervous system to create an exaggerated inflammatory response. However, in some cases, the onset of CRPS occurs after an injury or illness that did not directly damage the nerves in the affected area.
For this reason, CRPS has been classified into two categories:
- CRPS I: Also known as reflex sympathetic dystrophy (RSD), in this form of CRPS there is no evidence of peripheral nerve injury. This means that onset occurs after an injury that didn’t directly affect a nerve.
- CRPS II: Previously known as causalgia, this type of CRPS occurs after a peripheral nerve has directly been injured.
In both forms of CRPS, symptoms present themselves in the same way. The only difference between the two is the direct injury of a nerve.
Who is At Risk for Developing CRPS?
Complex regional pain syndrome is a rare disorder, however certain individuals are predisposed to developing it. CRPS generally appears in people aged 20 to 35. Seniors rarely acquire it, and very few children under 10. As of today, no one younger than age 5 has ever developed CRPS.
Complex regional pain syndrome affects women more than men. Likewise, those who have experienced a stroke, heart attack, or other trauma are more likely to develop CRPS.
Complex Regional Pain Syndrome Treatment Guidelines
Treatment for complex regional pain syndrome focuses on relieving pain and inflammation, thus helping to alleviate adjoining symptoms such as stiffness and limited mobility. Traditional care for CRPS can be incredibly invasive and relies heavily on medication to mask pain symptoms. Treatment relies on:
- Sympathetic nerve-blocking medications
- Intravenous anesthetics, such as Ketamine
- Antidepressants or anticonvulsants
- Topical creams and patches that numb the affected area
- Surgery to destroy nerves in the affected area
- Spinal cord stimulation through a battery-powered device inserted during surgery
For the most part, traditional treatment guidelines for CRPS fail to address pain or inflammation at the source. Methods which do aim at decreasing these symptoms are invasive, and possibly dangerous. Moreover, doctors disagree about whether or not surgical intervention to destroy nerves is actually effective. Therefore, patients can suffer through a procedure which is obliterating key nerves of the sympathetic system, without ever knowing if the process was even worth it.
Chiropractic Care for Complex Regional Pain Syndrome
The trouble with traditional medical doctors is they utilize a mechanistic approach to treatment. However, the body is not like a car – you cannot just treat certain parts, or give it a coat of polish to treat the damage under the hood. Every part of the body is connected, and maintaining proper nerve function overall can help to reduce CRPS symptoms. Unlike traditional CRPS treatment, chiropractic care for complex regional pain syndrome is neither invasive nor riddled with medication, and instead focuses on the body as a whole.
With chiropractic care, a thorough assessment will reveal possible areas of spinal and nerve dysfunction, helping to locate the possible presence and root cause of complex regional pain syndrome. The Vagus Nerve, one of the twelve pairs of nerves that run directly from the brain to the body, can become underactive as a result of an injury. When communication from this nerve slows down, the nervous system as a whole, malfunctions – hence, creating inflammation, pain, and a burning sensation.
Utilizing gentle spinal manipulations, a chiropractor can remove pressure from the Vagus Nerve, restoring proper function and causing it to shut down inflammation in the nerves. This improves the communication of the nervous system, helping to reduce inflammation and other symptoms of CRPS.
In addition to chiropractic adjustments, other components of chiropractic care for complex regional pain syndrome include:
- Heat and Cold Therapy: To reduce inflammation and soothe burning sensations.
- Physical Rehabilitation: Gradually allows patients to increase their activities and function without exacerbating pain.
- Exercises: A personalized plan to improve range motion and reduce stiffness.
Can CRPS Be Cured?
As the exact cause of complex regional pain syndrome has not yet been identified, doctors have not yet found a cure. However, a treatment which directly addresses nerve communication and soothing inflammation can drastically improve pain symptoms. While there is no cure, if treatment begins within a few months after symptoms initially appear there is a good chance they can ease up or completely stop.
If you or someone you love has been diagnosed with CRPS, get started on the path to healing today. With 10 offices in the South Florida area, the physicians at ChiroCare of Florida are prepared to help find relief and wellness with chiropractic care. Contact ChiroCare of Florida today to get started.
