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Concept
Complex regional pain syndrome
Summary
Complex regional pain syndrome (CRPS) is a form of amplified musculoskeletal pain syndrome in which pain from an physical trauma outlasts the expected recovery time. This type of AMPS must include a specific cause and often includes various visible changes, such as skin changes. Lack of these visible symptoms, or lack of an observed cause for the condition creates the diagnosis of diffuse amplified pain. Usually starting in a limb, it manifests as pain, swelling, limited range of motion, and/or changes to the skin and bones. It may initially affect one limb and then spread throughout the body; 35% of affected people report symptoms throughout their whole bodies. Two types exist: reflex sympathetic dystrophy (RSD) and causalgia. Having both types is possible.
The classification system in use by the International Association for the Study of Pain (IASP) divides CRPS into two types. It is recognised that people may exhibit both types of CRPS.
Clinical features of CRPS have been found to be inflammation resulting from the release of certain pro-inflammatory chemical signals from surrounding nerve cells; hypersensitization of pain receptors; dysfunction of local vasoconstriction and vasodilation; and maladaptive neuroplasticity.
The signs and symptoms of CRPS usually manifest near the injury site. The most common symptoms are extreme pain, including burning, stabbing, grinding, and throbbing. The pain is out of proportion to the severity of the initial injury. Moving or touching the limb is often intolerable. Patients may develop burning pain and allodynia in either form of CRPS. Both forms of the syndrome are also characterized by autonomic dysfunction, which presents with temperature changes (usually localized, but can be global), cyanosis, and/or edema.
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