CRPS, or Complex Regional Pain Syndrome, is a nerve pain condition that affects the nerves, skin, muscles, and bones. It is characterized by severe, persistent pain that is out of proportion to the initial injury or event that caused it. CRPS usually affects the limbs and can have a significant impact on an individual’s quality of life, mobility & function.
When Pain Becomes The Problem…
Pain is part of the normal experience and serves as an alert function in presence of injury. But when pain doesn’t go away and becomes worse and worse there is a new problem to address.
Pain receptors, called nociceptors, are located throughout the body and respond to harmful stimuli such as high temperatures, pressure, or tissue damage. These communications are all “broken” in CRPS patients, spreading high pain alert messages to the brain instead of normal sensations. In simple terms, the brain reacts by sending resources to deal with the injury creating a constant state of “nerve inflammation”. This can result in a wide range of symptoms, including burning pain, sensitivity to touch, allodynia, muscle stiffness, and changes in skin color and temperature.
The heightened sensitivity to stimuli in CRPS is often referred to as hyperalgesia or allodynia, depending on the type of sensitivity. It is very hard for patients to explain or even be aware of this at play.
Hyperalgesia
Hyperalgesia is an increased sensitivity to painful stimuli and is defined as an exaggerated pain response to a normally painful stimulus. It is characterized by an increased intensity of pain compared to what would normally be expected, making even mild stimuli painful. For example if you suffer from CRPS and stub the toe in your healthy foot it will hurt way more than normal and can even trigger an onset of pain in the affected foot. One way to explain this to others:
” my body is extremely sensitive – all pain is perceived by the brain as a red hot alert. Getting a tooth filled can cause severe pain and inflammation”
Allodynia
Allodynia, on the other hand, is defined as pain in response to a stimulus that is not normally painful, such as a light touch, wind, clothes, bedding or gentle pressure, like tight clothing, standing, sitting or lying down on the affected area, crowds, loud sounds, strong smells, velocity / frequencies.
In allodynia, even non-painful stimuli are perceived as painful, making it a type of sensitization to stimuli that would normally not cause pain.
For example you may be unable to go to a concert and be around loud or high frequency sound systems:
A loud alarm can make me faint from pain
Both hyperalgesia and allodynia are common symptoms in CRPS and can contribute to the chronic and intense pain experienced by people with this condition.
The extreme nature of the symptoms can be very isolating. When air, wind, water and sounds hurt going outside can be challenging. Do not give up.
Types of CRPS
CRPS-I, also known as Reflex Sympathetic Dystrophy (RSD), occurs when there is no clear nerve injury. It is diagnosed based on the symptoms and signs present, and there is no confirmatory test.
CRPS-II, also known as Causalgia, occurs when there is a clear nerve injury. It is diagnosed based on the symptoms and signs present, as well as the presence of a nerve injury confirmed by nerve conduction studies or other tests.
CRPS Diagnosis and Treatment
Getting CRPS diagnosed can be a challenge since the disease is poorly understood and many doctors are unaware of it. Early treatment can lead to the best outcome, possible complete regression.
You will need to take action and seek early diagnosis and treatment. Read more about CRPS diagnosis here. (coming soon)
There is currently no known cure for CRPS, and treatment options are limited.
Treatment
Multifaceted Rehabilitation (usually in a hospital setting) by a team of pain specializing; doctor, physical therapist, occupational therapist, psychologist and social worker, can play a crucial role in the management of CRPS, specifically when done early.
Physical therapy is crucial to improve range of motion, and prevent muscle atrophy. Especially hydrotherapy where possible.
Sensory re-education, desensitization, graded imagery and mirror therapy can all help to “re-train the brain”. Occupational therapy to regain or find solutions for functionality.
Western Treatments
- Medications: There are a variety of medications used to manage the symptoms of CRPS. These may include pain relievers, anti-inflammatories, antidepressants, and anticonvulsants, among others.
- Physical therapy: There are many different types of physical therapy, you should try as many as possible if you suffer from CRPS. Here are some of the different types:
Stretching and range of motion exercises: can help maintain flexibility and improve mobility in the affected limb.
- Hydrotherapy – involves exercising in a pool or other water-based environment. The buoyancy of the water can help reduce the pressure on the affected limb and make it easier to move and exercise. The resistance of the water can also help improve strength and range of motion in the affected limb.
Resistance training: can help improve strength in the affected limb, which can help improve overall function and reduce pain and discomfort.
Cardiovascular exercise can help improve overall fitness and reduce pain and discomfort, as well as improve mood and reduce stress.
Rehabilitative Pilates: a type of exercise that focuses on improving core strength, flexibility, and balance. It can be helpful for individuals with CRPS, as it can help improve overall function and reduce pain and discomfort.
Tai Chi: a type of exercise that involves slow, controlled movements and deep breathing. It can be helpful for individuals with CRPS, as it can help improve balance, reduce stress, and improve overall function.
Massage therapy: can help reduce muscle tension, improve circulation, and promote relaxation in the affected limb. This can help reduce pain and discomfort and improve overall function.
- Nerve blocks: Nerve blocks involve injecting medication into the affected nerve or nerves to block the pain signals.
- Spinal cord stimulation: Spinal cord stimulation involves implanting a device that delivers electrical pulses to the spinal cord, which can help reduce the pain signals.
- Graded motor imagery: Graded motor imagery involves a series of exercises and activities that are designed to retrain the brain and improve the communication between the brain and the affected limb. This can be particularly effective for early intervention or in the case of mirror spreading.
Alternative Therapies
Alternative therapies such as acupuncture, aromatherapmassage, and relaxation techniques may also be helpful if possible due to the extreme sensitivity to touch.
There is only so much medication a person can take, using age old therapies and techniques like mindfulness, breathing and relaxation skills, aromatherapy, diet, massage are important to every aspect of getting through the day.
It’s important to focus on self-care and positive thinking. Living with CRPS can be challenging, but there are ways to manage the condition and regain some level of functionality and be the best you can be within the constraints of the disease.
It is up to you to keep moving no matter what, we are here together on this journey.
The Pain is Real
It is important to note that the pain associated with CRPS is not “in your head.” It is a real, physical condition caused by a malfunction in the nervous system.
The pain and symptoms of CRPS can have a serious impact on your like, making it difficult or impossible to work or remain mobile. While Western medicine has limited options for treating CRPS, at CRPSJourney we explore alternative options as well, including a more holistic approach.
It is important to remember that every CRPS patient is different, and may present differently and respond uniquely to treatment.
Contact us to share your story and stay informed on the latest advancements and support for those living with CRPS. Join now and take the first step in your journey towards understanding and managing CRPS.
Additional Resources
- PainBC – https://painbc.ca/
- RSDSA – https://rsds.org/
- Burning Nights CRPS Support – Burning Nights CRPS
- Reflex Sympathetic Dystrophy Syndrome Association – https://rsds.org/
- American Chronic Pain Association – https://www.theacpa.org/
- Pain UK – https://painuk.org/
- CRPSUK – CRPS UK
- American RSDHope – RSD Hope
- The Chronic Pain Association of Canada – Chronic Pain Canada
- Clinical Trials – https://clinicaltrials.gov/ct2/results?cond=CRPS
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