Lawyers for CRPS Compensation Claims

Complex Regional Pain Syndrome, (formerly known as Begum Syndrome and also Reflex Sympathetic Dystrophy), is a chronic and progressive condition which affects many people around the UK and across the world. The condition, often abbreviated to CRPS, is characterised by complex regional pain and in most instances it is triggered by an injury and the pain felt is out of proportion with the injury.

Complex pain syndrome usually affects a single limb but sometimes spreads into other parts of the body. It can affect every part of the limb in question from the skin to the joints and often CRPS syndrome manifests in feeling extreme pain even when the slightest touch or movement is felt.

The CRPS UK doctors treat is often caused by traumatic incidents such as car accidents or slips, trips and falls, with the resulting injury developing into CRPS or related pain syndrome conditions for no known reason.

The definition of CRPS has changed regularly through the years and there are now two separate recognised types:

• Type I – often known as reflex sympathetic dystrophy and shows no evidence of nerve lesions
• Type II – often known as causalgia and has clear evidence of nerve lesions and damage
  
  

Complex regional pain syndrome can cause a wide range of symptoms and lead to a loss of mobility and many things which make getting on with day to day life quite difficult. Doctors may carry out a wide range of tests before you receive a diagnosis of CRPS but in the end, having the right diagnosis leads to the right treatment.

The outlook for people living with CRPS is entirely dependent upon the individual case, as no two cases are the same. Some people find the condition settles within a number of weeks whilst others have to accept it is a lifelong syndrome and something they will learn to live with. The treatment programmes for CRPS also vary greatly and often include pain relief, physiotherapy and self-management and lifestyle changes. Some individuals may also require psychological support which many doctors will make a referral for.

Anyone can develop CRPS following an accident or injury but it is unknown why some people go on to develop the condition following trauma while others will go on to make a full recovery. Many cases of CRPS occur after a forceful trauma to a limb from incidents such as road traffic accidents, but, more rarely, it can be caused by heart attacks, surgery and infections. The exact cause of the disorder is still unknown. It is thought to be caused by an injury or dysfunction in the central or peripheral nervous systems causing those suffering from CRPS to experience severe pain.

It is also believed by some that the symptoms are too complex to be as a result of one factor and that CRPS is caused by several different conditions. It has also been suggested that genes may play a role in who develops CRPS after an injury or trauma. 

CRPS is a lifelong condition known for being very hard to diagnose, as there is no single test to give you a yes or no answer. CRPS diagnosis is mainly based on the symptoms you present, the results of a physical examination and several different tests that can give a clearer picture of the type of pain you’re suffering from and whether there is any other underlying cause.

Below are just some of the tests you may undertake 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, 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; 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; most of these are inside local hospitals. As soon as you receive your diagnosis, your doctor should refer you 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 in CRPS have accepted that it usually has three main stages (though it isn’t a systematic condition, and not all of the stages may be followed or experienced by each individual). Some people develop severe symptoms immediately, whereas others may never experience the later stages. Here is a closer look at the three CRPS stages the condition may manifest into.

Stage One

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

• 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
• Joint pain or swelling
• The rapid growth of nails or hair
• Blotches or skin tone and feel changes, including shininess, additional perspiration and thinness.

   

Stage Two

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

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

   

Stage Three

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 depending on the cause of their condition.

CRPS remains challenging to manage as there is so much unknown, and it can take some time to get to a diagnosis. The condition also has no cure, so it is a case of managing the symptoms and living with the syndrome in the best possible way. Treatment depends on the individual situation and symptoms, and many doctors will refer their patients for physical and psychological medicinal treatment.

CRPS comes in two forms: 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.

According to Mayo Clinic, 90% of all sufferers of CRPS are diagnosed with CRPS Type 1, which is different from Type 2 as it occurs after an illness or injury that didn’t cause any direct damage to the nerves in the affected limb.

CRPS Type 1 is particularly challenging to diagnose as there is no damage to the nerves, 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, hyperalgesia, and disproportionate pain to touch, movement or pressure.

Testing for CRPS Type 1 includes a wide range of scans and tests which doctors can organise, most of which are used to rule out other conditions to reach a diagnosis. Blood tests, MRI scans and further examination, including nerve conditioning testing, may be required before diagnosis.

CRPS Type 2 is different from Type 1 because of tangible nerve injury and also because the pain doesn’t migrate from the original site. CRPS Type 2 is caused by trauma to a large nerve in one of the limbs, usually in the peripheral nervous system. CRPS Type 2 can be caused by a mild injury or something more traumatic, such as a car accident or a fall from a 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.

Symptoms of CRPS Type 2 include the burning pain already mentioned, sweating, discolouration of the skin in the affected area, hyperalgesia, and extreme pain felt from disproportionate action such as light touch, pressure or movement.

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.

There are no specific tests for CRPS Type 2, and like Type 1, it is mainly diagnosed through symptoms by professional doctors and specialists who may carry out a range of tests, such as MRI scans and blood tests, to rule out other conditions rather than pinpoint CRPS.