Chronic regional pain syndrome (CRPS) is a painful condition that can affect the arms, legs, hands or feet. The pain can spread into the entire length of the limb that is involved. This syndrome may occur after direct insult to the area, sometimes after a motor vehicle accident, sports injury, or surgery, but may occur without any direct injury or trauma. CRPS usually affects one limb, such as an arm or leg.
SYMPTOMS
Patients with CRPS present to the clinic with a change in the color and temperature of the skin of the affected limb or body part.
These patients also complain of a burning sensation and hyperhydrosis ( abnormal sweating). Some patients with CRPS can develop
a dermal sensitivity, where the lightest touch causes severe pain. The pain is normally out of proportion to the severity of the initial injury. The syndrome presents itself with pain, redness, swelling, and an increase in temperature. As CRPS progresses, many patients experience a decrease in the ranges of movement of the affected area,lea ding to musclular contractures, prolonged spasms, etc. Many patients will experience changes in skin texture, loss of hair of the affected area, and nail discoloration and lack of growth. . Symptoms may change with time and varies in patients with CRPS. Unfortunately, sometimes the changes are permanent. The patients that are uner alot of stress have much more difficulty with this illness
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CAUSES
There are two types of CRPS with similar symptoms with different causes. The first type occurs after an illness or injury that does
not directly affect the nerves. This is the most common form of CRPS. The second type follows a particular nerve injury. It is thought that a direct /indirect trauma causes hypersnsivity of the Sympathetic Nervous System leading to an auto-immune response, thus causing the body to over respond with an inflammatory process. This theory has not been proven, there is little hard evidence to substantiate a cause for this syndrome.
TREATMENT
To date there is no effective cure for this syndrome. Chiropractic, Massage Therapy, Physical therapy may be effective in improving the ranges of motion of the joints and limbs that are affected. Low volt current, Ultrasound, and some other modalities may help
normalize nerve conduction, and improve blood flow to the area in question. Often, patients are referred back to their MD for further assessment. Topical analgesics, Cortisone creams, spinal nerve blocks, auto-immune medication, anti-inflammatories may help with symptoms.
PROGNOSIS
The prognosis for those patients with CRPS is guarded. Some respond to treatment quickly, especially when the condition is treated in the early stages. Patients that wait too long before seeking treatment have a poor prognosis as some of the changes to the muscle, skin, nails, hair, etc., may be permanent.
