About Complex Regional Pain Syndrome (CRPS)

Complex, or Chronic, Regional Pain Syndrome (CRPS) is, as the name suggests, a complex pain condition whereby a person develops a chronic pain in one, or more, of their limbs. The pain is sometimes described as burning and usually is the result of an injury, of varying degrees, with the pain experienced being disproportionate to the severity of the injury.

In some cases CRPS can develop without an injury being sustained, but if an injury is suffered it is important to seek specialist legal and medical advice.

CRPS is divided into two categories;

  • Type 1 – results from a peripheral nerve injury
  • Type 2 – in the absence of nerve injury

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  • Causes
  • Diagnosis
  • Causes

    The cause of CRPS is unknown, although it is believed to be caused by damage to the peripheral and central nervous systems.

    The central nervous system is made up of the brain and spinal cord, whilst the peripheral nervous system involves nerves signalling from the brain and spinal cord to the rest of the body.

    CRPS can also come on following other health problems, such as a head injury, stroke, heart attack or prolonged bed rest.

    Whilst CRPS can occur following a minor injury, such as sprained ankle or cut finger, it more commonly occurs following nerve damage or a fractured bone.

  • Diagnosis

    Diagnosing CRPS can be difficult, particularly in the early stages of the condition.

    The Royal College of Physicians recommends that when diagnosing CRPS the “Budapest criteria” is used. This requires all of the following to be present;

    • Pain which is disproportionate to the initial injury
    • At least one sign in two or more of the categories below
    • At least one symptom in three or more of the categories below
    • No other diagnosis would better fit

    The categories include;

    • Sensory – alloydnia, pain caused by light touch (temperature, joint movement or deep somatic pressure). These count as symptoms or signs
    • Vasomotor – signs/symptoms of temperature differences and/or skin colour changes and/or skin colour asymmetry
    • Sudomotor/oedema – signs/symptoms of oedema (fluid swelling) and/or sweating and/or sweating asymmetry
    • Motor/trophic – reduction in range of motion and/or motor dysfunction (e.g. weakness, tremor) and/or trophic changes of the hair, nail or skin