Complex regional pain syndrome or CRPS

What is complex regional pain syndrome or CRPS?

Also known as :

CRPS (Complex Regional Pain Syndrome), Algodystrophy or Sudeck disease.

This is an abnormal regional inflammatory reaction of the body following an accident and/or surgery, causing pain disproportionate to the initial problem. The origin is not clearly understood, but is linked to an imbalance between the information sent by the limb’s nerves and the analysis in the brain.

What are the symptoms of complex regional pain syndrome?

As a rule, patients present inflammatory symptoms such as pain, swelling, redness, heat and loss of function. The hand is often clammy and changes color. These signs usually appear a few weeks after the accident or operation, and can affect the entire affected limb. These symptoms are disproportionately present compared to the “standard” inflammation that occurs after trauma.

How to diagnose?

Diagnosis is based on your complaints and the appearance of your hand, without the need for further examination. In some cases, certain tests may be ordered, especially to rule out another cause for the symptoms. CRDS can be diagnosed even if the origin is unknown.

• X-rays

They may show bone demineralization suggestive of CRDS.

• Bone scan

The examination consists of injecting a weakly radioactive product into a vein and then measuring it.

X-ray or CT scan.

Treatments for complex regional pain syndrome

Treatment is carried out by a multidisciplinary team to take into account the various aspects and limitations of the disease. This includes doctors specializing in pain management, physiotherapists and occupational therapists, psychologists or psychiatrists in addition to your surgeon. Surgery is not part of the treatment, except in very rare cases.

• Medical

Rehabilitation forms the basis of treatment. Intensive occupational and physical therapy is aimed at treating pain, reducing swelling and joint stiffness, and reintegrating the limb into everyday activities.

Pain management often requires the skills of an anesthetist specialized in pain management (pain center).

A bio-psycho-social approach is often necessary, i.e. taking into account not only the biological factors of the disease, but also the psychological and social factors influencing it.

Drug treatment

Pain is treated with both conventional drugs(paracetamol (Dafalgan®), ibuprofen (Irfen®)) and less common ones(cortisone),

bisphosphonates, calcitonin, pregabalin, amitriptyline).

• Surgical

In rare cases where CRPS is linked to nerve compression or injury, surgery may sometimes be proposed.

What’s new?

Treatment is long-term, generally lasting from six months to two years. It is important to start treatment as soon as possible, as this can limit the after-effects of the disease.

Complications of complex regional pain syndrome

CRPS can result in chronic pain and limited mobility and strength in the hand and wrist.