CRPS Solicitors for Complex Regional Pain Syndrome

Complex Regional Pain Syndrome (CRPS) is a lifelong condition which is known for being very hard to diagnose, as there is no single test which can be carried out to give you a yes or no answer.

CRPS diagnosis is mainly based upon the symptoms which you present, the results of a full physical examination and a number of different tests which may be carried out and which can give a clearer picture of the type of pain you’re suffering from and whether there is any other underlying cause for it.

Below are just some of the tests which may be carried out if your doctor suspects you may have CRPS:
Blood tests: carrying out blood tests can discover whether you have an underlying infection causing the pain or rheumatoid arthritis.
An X-Ray: an x-ray or bone scan on the affected limb can show any problems of bone thinning (osteoporosis) or any other abnormalities with the bones and joints.

MRI scan: used to find if there are any other underlying problems with your bones or tissue.

Nerve conduction studies: doctors may carry out tests which involve blocking the sympathetic nervous system with an anaesthetic. If they find that blocking this system relieves the pain, then they know they can focus on it as the cause of the pain.

Not all doctors will carry out every single one of these tests and not all of them are necessary to receive a CRPS diagnosis but it is best to be prepared for as many tests as possible, to guarantee you get the results that you need to start upon the right treatment plan.

After CRPS Diagnosis

Once your doctor has diagnosed you with CRPS the next step is usually a referral to your local specialist pain clinic and the majority of these are found inside local hospitals. As soon as you receive your diagnosis your doctor should refer you on so you can begin to get the treatment you need and see a downward change in the pain you are suffering.

Most doctors and specialists have accepted that CRPS usually has three main stages, although it isn’t a condition which is systematic and not all of the stages may be followed or experienced by each individual. Some people develop severe symptoms straight away whereas others may never experience the later stages. Here is a closer look at the three CRPS stages that the condition may manifest into.

Stage one sees changes which last one to three months and is characterised through:

• Changes to the temperature of skin – switching between warm and cold for no discernible reason
• Severe burning, aching pain in the affected area which worsens when touched in the slightest way
• Muscle spasms
• Join pain or swelling
• Rapid growth of nails or hair
• Blotches or changes to skin tone and feel including shininess, additional perspiration and thinness.

Stage two generally sees changes which last from 3 to 6 months and is characterised through:

• Slower hair growth
• Increasing pain which continues to worsen
• Cracked and easily broken nails
• Stiff joints
• Weakened muscles

Stage three is the beginning of changes which are irreversible and need dedicated pain management and include:

• Constant or near constant pain in the entire limb
• Muscle wasting
• Limited movement in the limb due to the tightened muscles and tendons

The progress through these stages is not necessarily sequential, as previously mentioned and there is nothing to say individuals won’t experience one of the stages and go through another. There is also no research to suggest which CRPS stages may be experienced by each individual dependent on the cause of their condition.

Complex Regional Pain Syndrome is a chronic pain condition which, since first being discovered, has been split into two further types. It’s a condition which usually affects an area of a single limb but it can spread and it is usually related to a trauma or injury in the area where the pain is coming from.

There are two types of CRPS, referred to as CRPS Type 1 and CRPS Type 2. CRPS Type 1 was formerly known as Reflexive Sympathetic Dystrophy Syndrome or RSD, although most people, especially medical professionals will now call RSD CRPS as this is the universally accepted term.

Diagnosing CRPS Type 1 is particularly difficult as there is no damage to the nerves and usually no damage to the bone and little damage to the tissue. The pain is out of proportion to the accident or injury that occurred and the main symptoms are usually allodynia, continuing pain, and hyperalgesia, disproportionate pain to touch, movement or pressure.

CRPS Type 2 is different to Type 1 because of the tangible nerve injury which can be found and also because the pain doesn’t migrate from the original site. Whilst Type 1 may result in pain in the whole limb over time, CRPS Type 2 is a condition which remains specific to the original place that was injured.

Complex Regional Pain Syndrome Type 2 is the rarer of the two conditions known as CRPS. CRPS Type 2, formerly known as causalgia, is a severely painful and chronic condition which develops as a result of an injury to a peripheral nerve. The pain associated with CRPS Type 2 is usually described as an intense burning which doesn’t subside and the pain is specific to the affected area, due to the injury to the nerve.

CRPS Type 2 is caused by a trauma to a large nerve in one of the limbs, usually in the peripheral nervous system. CRPS Type 2 can be caused by a simple injury or something more traumatic such as a car accident or a fall from height. The disease progresses over time and can result in loss of movement and mobility in the affected limb, alongside increased pain. CRPS Type 2 pain is known to become resistant to painkillers over time.

CRPS Type 2 can also change the rate at which hair and nails grow and it’s also more common that the joints in the affected area may seize up or spasm.

The characteristic symptom of CRPS is pain. Commonly described as a burning, intense pain specific to a single location on one of the body’s limbs, it is a pain which is out of proportion to the severity of the injury or the trauma which had occurred. CRPS pain is chronic, often getting worse over time rather than improving and often leads to the development of further symptoms. The symptoms and their severity vary from person to person and may change.

Some of the common symptoms include:

• Extreme sensitivity to pain that is out of proportion to the injury or trauma
• Excessive or prolonged burning pain after contact – as the affected area has increased sensitivity, even light contact can cause extreme pain
• Continuous pain that gets worse over time
• Experiencing pain from something that shouldn’t be painful such as a light touch or a change in temperature
• Changes in skin, hair and nails – skin may become blotchy, dry or scaly, nails crack and can become grooved or brittle, and hair often becomes thin
• A decrease in range of motion of the affected limb or limbs
• Stiffness of limbs
• Insomnia- difficulty sleeping
• Changes in skin temperature- the affected limb may feel warmer or cooler than the opposite limb
• Changes in skin texture
• Tremors and muscle spasms
• Stiffness and swelling of the affected joints

The symptoms that usually occur first are pain, swelling, changes in temperature and hypersensitivity. The condition is irreversible and may spread to other limbs in the body, but, with a combination of medicine and other treatments, most people experience a reduction in their pain within a few years.

Sometimes, although rarely, CRPS can cause complications, including ulcers and skin infections, muscle atrophy and muscle contractures in which the muscles shorten causing loss of movement.