Complex Regional Pain Syndrome (CRPS) Physiotherapy

Previously known as Reflex Sympathetic Dystrophy (RSD), Complex Regional Pain Syndrome (CRPS) is typically a painful and progressively disabling condition.

Patients and doctors and us therapists are often shocked, as CRPS can happen with seemingly mild stuff, such as

  • scrapes
  • bruises
  • sprains
  • strains

and not always major stuff like fractures.

It’s complex, affecting an area (hence “region”). An estimated 80,000 to 100,000 people living in United States are diagnosed with CRPS every year, and most patients will need a team of practitioners to care from them, including physiotherapists.

What’s Complex Regional Pain Syndrome (Crps)?

CRPS is a multi-system disorder that’s characterized by

  • moderate to severe pain
  • pathological changes of the bones, joints, and skin
  • excessive sweating
  • tissue changes including swelling
  • hypersensitivity even to light or light touch

2 types of CRPS

  • Type 1: not resulting from a distinct nerve injury
  • Type 2: resulting from a distinct nerve injury

CRPS involves the

  1. central nervous system
  2. autonomic nervous system and
  3. immune system

Eventhough studies and research has not yet determined exactly what causes CRPS, the good news is that physiotherapy has shown to be quite beneficial in

  • managing symptoms
  • improving function and
  • increasing the quality of life for people with CRPS

How does Complex Regional Pain Syndrome feel like?

Patients with CRPS report

  1. Extreme sensitivity to light touch—a symptom known as tactile hyperesthesia. Very common everyday activities, such as applying lotions or creams, clothing, bathing or even accidental brush with fabrics or surfaces can be very uncomfortable and painful.
  2. Significant pain, that’s often described as sharp, stabbing, throbbing or burning that’s much more extreme or even unusual from the original injury.

Specific signs and symptoms may include

  • Pain and sensitivity to touch.
  • A higher or lower skin temperature in the affected limb eg limb may be warm, cold or hot
  • Discoloration of the affected limb eg paler, white, darker, redder
  • Awkward positioning of the affected limb as a result of sustained muscle contractions (this is known as dystonia, and it happens in about 25% of CRPS cases.)
  • A change in the appearance of hair and nails on the affected body part — more hair, less hair compared to the other body part
  • Swelling
  • Additional sweat or perspiration even in cool environments

Additional other symptoms reported by people with CRPS include increased

  • sleeping problems: difficulty falling / staying asleep
  • irritable
  • depressed
  • decreased sexual interest or desire
  • tiredness, fatigue
  • loss of memory or cognitive function

How is CRPS diagnosed?

The patient will need a specialized doctor such as neurologist who’s familiar with CRPS. They will try to rule out the possibility of other conditions with similar symptoms such as

  • infections
  • lyme disease
  • peripheral neuropathy

before they have a conclusive or definitive diagnosis.

How physiotherapy can help

Physiotherapists can play an important role in managing and treating CRPS. They will work closely with you to co-create specific treatment plans to work on the symptom and conditions.

Treatments for CRPS may include

Where To Next?

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