Complex regional pain syndrome (CRPS), also called reflex sympathetic dystrophy syndrome and causalgia, 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.
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. investigators in Sweden have reported highly unusual data that makes it difficult to explain the genesis of RSD / CRPS simply on the basis of disuse. They carried out a pathological analysis of peripheral nerve and muscle taken from amputated legs of eight patients with RSD / CRPS. In all patients, amputation was performed because the painful (hyperpathic) limb was useless or subject to recurrent infections. Skeletal muscle specimens were abnormal in all cases, but myelinated nerve fibers were normal, and in half the patients there was a loss of unmyelinated fibers.
These findings suggest a microangiopathy in the affected limbs. Thus, patients with RSD / CRPS have tissues that are truly abnormal, and abnormal in ways that cannot be readily explained by disuse and/or psychological factors. 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. Therapies used include psychotherapy, physical therapy, and drug treatment, such as topical analgesics, narcotics, corticosteroids, antidepressants and anti-seizure drugs. Other treatments include: Sympathetic nerve blocks, surgical sympathectomy, Intrathecal drug pumps, Spinal cord stimulation.