Effects of CRPS

The most common symptom of CRPS is a burning pain.

Other physical symptoms may include;

  • Sensitivity to touch
  • Temperature changes
  • Abnormal sweating
  • Allodynia (pain caused by a gentle touch e.g. clothes touching skin)
  • Changes in skin colour/texture
  • Changes in hair/nail growth
  • Stiffness/difficulty moving the affected limb

Psychological symptoms that may be experienced are;

  • Difficulty relaxing
  • Lack of confidence
  • Depression
  • Feeling unable to cope

Over time symptoms may spread and usually do so in one of three ways;

  • Continuity – symptoms gradually spread out from the initial source
  • Mirror image – symptoms spontaneously occur in the opposite limb
  • Independent – this can be spontaneous or as a result of further trauma

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  • Treatment
  • Spinal cord stimulation
  • CRPS and sleep deprivation
  • Rehabilitation
  • Professionals
  • Treatment

    Treatment for CRPS is about treating the symptoms, as the cause is unknown.

    The earlier treatment is started the more effective it will be.

    There are three main treatment methods, which are often used in combination, they are;

    • Physical Therapy – such as physiotherapy, aims to improve movement and prevent muscle wastage
    • Medication – anti-inflammatory painkillers to relieve pain e.g. ibuprofen
    • Counselling – to enable people to cope better emotionally with living with chronic pain
  • Spinal cord stimulation

    There are two specialised treatments associated with CRPS;

    This involves a device being placed under the skin of the stomach or buttocks, which then produces mild electrical pulses that are sent to the spinal cord.

    The pulses cause a tingling sensation in the part of the body that normally experiences pain. The amount of stimulation experienced can be adjusted as the pain increases or decreases, and if necessary the device can be removed.

    NICE (The National Institute for health and Clinical Excellence) have produced guidance which states that spinal cord stimulation will only be considered if;

    • Pain is still being experienced six months after of trying other treatments
    • A trial of the stimulation has been successful

    Pain management programme

    Aims to improve the quality of life of those suffering with CRPS and enable them to manage their pain more effectively.

    It includes help from professionals, including medical experts, physiotherapists, psychologists and occupational therapists.

  • CRPS and sleep deprivation

    Insomnia is a common problem amongst those who have CRPS, with the main cause of the difficulty getting to sleep and staying asleep being pain.

    This occurs because the mind begins to relax and as there are no other distractions the mind focuses on the pain. Once asleep a sufferer of CRPS may be awoken by pain due to rolling on to their affected limb.

    Lack of sleep mixed together with the daily fatigue felt by sufferers can lead to low energy levels, low moods and have a significant affect on the ability to cope with the condition.

    Symptoms of insomnia;

    • Difficulty falling asleep despite being tired
    • Waking frequently during the night
    • Difficulty getting back to sleep after waking
    • Waking early in the morning
    • Drowsiness, fatigue or irritability during the day
    • Difficulty concentrating
    • Reliance on sleeping pills or alcohol

    Treating the insomnia is essential as sleep is required to aid the body’s recuperation, which is particularly important in those with CRPS.

    In order to establish a good sleeping pattern it may be beneficial to;

    • Establish fixed times for going to bed and waking
    • Relax before bed e.g. warm bath an hour before
    • Avoid napping in the day
    • Avoid caffeine, nicotine and alcohol late at night
    • Maintain a comfortable environment e.g. not too hot/cold, bright
    • Avoid watching television in bed

    In severe cases of long term insomnia, lasting more that 4 weeks, cognitive behavioural therapy for insomnia (CBT-I) may be recommended.

  • Rehabilitation

    For anyone suffering with CRPS rehabilitation should be considered and started as early as possible.

    Treatment and support from experts in the fields of physiotherapy and occupational therapy are very important.

    The rehabilitation process will include assistance in using the affected limb, using gentle exercises and making the limb less sensitive.

    Other treatments during the process will assist to use the limb more normally and reduce any oedema (fluid swelling).

  • Professionals

    The complex nature of the condition will usually require the input from a number of different professionals, for example;

    • Physiotherapist
    • Occupational Therapist
    • Neurologist
    • Psychologist
    • Pain relief specialist
    • Social Worker