Date issued: July 2019
For review: July 2021
Ref: C-374/GB/Occupational Therapy/Complex Regional Pain Syndrome
What does CRPS stand for?
Complex: It affects many systems in the body.
Regional: It usually affects one area of the body.
Pain: Severe pain is the hallmark of the disease.
Syndrome: A collection of symptoms for which the exact cause is unknown.
What is CRPS?
CRPS is considered to be a condition affecting the nervous system. Its main feature is a persistent, burning pain in one of the limbs. However it can spread to include more than one limb. CRPS can cause limb dysfunction and psychological distress. It is not well understood, and can be difficult to diagnose.
What causes CRPS?
It is not yet known exactly what causes CRPS. It can be triggered by a trauma (which can be mild or serious) e.g. fracture, or a sprain. In other cases it develops without any obvious trigger factor.
It is not known why some people go on to develop CRPS following an injury, although it is thought that communication pathways between the affected limb and the brain may be disrupted so that pain persists after the original injury has healed.
What are the symptoms?
CRPS is characterised by:
- Severe pain, this can be burning aching or an “electric shock” type pain.
- Extreme sensitivity to touch, the skin can be sensitive and painful even to a light touch, e.g. clothing, breeze etc. This is known as allodynia.
- Sweating, wet, clammy.
- Skin changes, skin can become shiny or thickened. There can be an increase or decrease in either hair or nail growth.
- Alterations in skin colour – skin can appear mottled, white, blue, purple or red.
- Change in temperature of the affected limb – hotter or colder.
What is the outlook?
It is difficult to predict how CRPS will progress, or how long it will last, in any individual. It is felt that the sooner you are diagnosed, and start therapy, the more chance there is of recovery. In some cases, people may be left with some degree of permanent pain or disability.
How can it be treated?
It is important to follow the advice of the team treating you. Treatment may include:
- Occupational Therapy
Using your affected limb as much as possible is imperative which may be achieved with:
- Medication (not always effective)
- Desensitisation (helping the limb to feel less painful and more normal when touched)
- Mirror therapy
- Imagined movements
- Relaxation and other ways of managing pain
- Restoration of normal activities
- Vocational support
Your clinician / therapist will be able to advise you regarding the above treatments, and your program will be individualised to your specific needs.
Useful Resources and Links:
Complex Regional Pain Syndrome – Arthritis Research UK www.arthritisresearchuk.org/arthristininformation/arthritistypesymptoms/complexregionalpainsyndromw.aspx
American Association for CRPS
Blake D (2006) “Insights into pain and suffering: A guide to Neuropathic Pain and Complex Regional Pain Syndrome known as Reflex Sympathetic Dystrophy”
Broome, A and Jellicoe, H (1987) “Living with Pain: A self-help guide to managing pain”. British Psychological Society: Leicester
Reflex Sympathetic Dystrophy Association (RSDSA)
CRPS Network UK
Information leaflets for employers, friends and family and healthcare professionals:
UK charities specific to CRPS
This list is not exhaustive – there may be additional charities, and the inclusion of these two charities must not be taken as an endorsement of any content posted on their websites.