CRPS I, CRPS II and RSD

WHAT IS Complex Regional Pain Syndrome? (CRPS) An Overview

Because CRPS is quite often a "hidden" condition many patients have additional problems because people either do not understand the pain they are in, or worse, disbelieve the pain they report feeling. You can help others understand the condition by asking them to read the RSD UK website, the patient information leaflet (available on request) or buying a copy of the book "Insights into Pain and Suffering".

There are two types of CRPS. CRPS I, previously known as Reflex Sympathetic Dystrophy, CRPS type II previously known as Causalgia. For more information about the two types of CRPS please see "Type 1 and Type II" link. In the majority of cases the name it is given is not important - it is the appropriate and timely treatment that is important. The treatment is usually the same for both types; however some treatments may be unsuitable for some patients depending on the site of the CRPS and any underlying conditions or nerve lesions.

SYMPTOMS

Symptoms vary considerably between patients but can also vary drastically in one patient over the course of a day. Symptoms include:

• Pain, often described as burning or hot, it is disproportionate to the original injury
• Allodynia (pain from what should be a non-painful stimulus, such as a breeze or wearing clothes)
• Hyperalgesia (increased pain from a stimulus)
• Abnormal sweating in the affected area
• Temperature and skin colour changes (red, mottled, purple etc)
• Oedema extending behond the region of trauma
• Abnormal growth of hair & nails
• Muscle atrophy
• Body perception disturbance

The patient may also report

• Muscle spasms, shaking
• Odd sensations
• Referred sensation or pain [synchiria] (feeling touch in another part of the body)
• Rash
• Depression (as a result of the condition) & anxiety
• Dystonia (abnormal painful muscle contractions)

CRPS may cause extreme pain (some people report only mild pain or discomfort), it may exaggerate normal stimuli such as the touch from clothes, a breeze of wind, a drop of water causing the stimulus to feel excrutiatingly painful (allodynia); the pain is often reported as burning even if the affected area feels cold to touch. In a number of patients the pain doesn't stop or subside and it can drastically affect the their mood and ability to cope with everyday stresses.

The condition can change rapidly, at times dramatically, this can be frightening to the patient and cause anxiety. Patients may find it difficult to explain their symmptoms (such as it is felt to burn but feels cold to touch), how a normal stimulus such as a breeze can cause distressing pain or the bizzare symptoms that may occur (feeling like ants crawling under the skin, or the limb feeling much bigger than it is).

The above are all discussed in greater depth in the book "Insights into Pain and Suffering" available from RSD UK.Treatment can be by way of physiotherapy, medications (tablets, medicines), nerve blocks (used alongside intensive physiotherapy), hydrotherapy, phsycotherapy, tens machines, spinal cord stimulators, morphine pumps and pain management techniques. Alternative therapies such as hyperbaric oxygen therapy (HBOT), accupuncture or reflexology may also help relieve the pain.

INFORMATION SOURCE: http://www.rsd-crps.co.uk/crps.htm

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