Complex Regional Pain Syndrome / Reflex Sympathetic Dystrophy Syndrome

Complex Regional Pain Syndrome (CRPS) is a disease characterized by pain that is seemingly out of proportion and dysfunction of the nervous system.  This rare syndrome can be caused by trauma and even surgery. It is a very unfortunate occurence.

The pain CRPS is said to be burning in nature, knife-like, sharp or stinging, and is caused by the slightest touch or movement. Sometimes the blood vessels are affected in which the arteries and veins constrict causing whiteness and duskiness of the skin as well as causing a bluish-gray discoloration. Also the sweat glands are affected causing intermittent episodes of perspiration followed by extreme dryness of the skin. Swelling of the affected limb can occur and fluctuate.

Stages of CRPS

Stage 1 (1-3 months) – The foot is swollen, soft an puffy. Increased pain and hypersensitivity to touch is noted. Increased sweating noted.

Stage 2 (3-6 months) – Very swollen and skin is tight. Range of motion in the joints is limited. Loss of muscle tone noted. The skin is mottled and blue/gray.

Stage 3 (6-9 months) – The foot is cool and dry with a white discoloration. The skin is taut, waxy and thin. Stiffness of the joints is noted.

Other causes of this disorder include nerve injury, fractures, sprains and crush injuries. A person may have an increased susceptibility if they have sweating of the palms in the winter, cold insensitivity, and an intolerance to pain.

Treatment must be performed very quickly upon diagnosis. Consultation with a pain specialist, neurologist, or anesthesiologist is warranted whenever suspicion arises.

Treatment includes nerve injections, anti-depressants, anti-inflammatory medications and counseling. Sometimes spinal injections are performed.

It is thought to perform motion exercise and other forms of physical therapy is needed. Avoidance of immobilization is necessary.

This problem is very serious and can be quite debilitating. If you have this condition please contact Dr. Eric Silvers or Dr. Kory Williams at Advanced Foot & Ankle Center so they may orchestrate a team approach to remedy the situation as soon as possible.