CRPS is RSD = Pain

Complex Regional Pain Syndrome - Information - Symptoms - Treatment

REVIEW

Reflex sympathetic dystrophy syndrome, or RSDS, is known by many names. These include causalgia, Sudeck’s atrophy, shoulder-hand syndrome and regional complex pain syndrome. Complex Regional Pain Syndrome (CRPS) is the current name of Reflex Sympathetic Dystrophy Syndrome (RSDS).

CRPS is a very debilitating disorder that begins after nerve injury. The nerves become hypersensitive and severe pain is felt in situations that are not normally painful. CRPS is a chronic pain syndrome with two forms. CRPS 1 currently replaces the term "reflex sympathetic dystrophy syndrome". It is a chronic nerve disorder that occurs most often in the arms or legs after a minor or major injury. Type one can occur in the absence of nerve injury. Type two occurs after damage to a nerve in the injured arm or leg. CRPS 1 is associated with severe pain; changes in the nails, bone, and skin; and an increased sensitivity to touch in the affected limb. In most cases CRPS has 3 stages. Often, however, CRPS does not follow this progression. Some people go into the later stages almost immediately. Others remain in Stage 1 indefinitely.

The pain felt with CRPS is out of proportion in intensity, distribution, and duration of what would be expected from the initial injury. The nature of the pain often fluctuates with external stimuli (changes in temperature/touch) and internal stimuli (life stress/illness). Eventually movement can become limited due to pain and muscle weakness and decreased range of motion develops in the affected arm or leg.

Treatment should be started as early as possible. This may prevent the disease from progressing. Treatment usually includes a combination of therapies. Treatment usually includes a combination of therapies, such as:
Medications -- pain medicines, steroids, blood pressure medicines that work on the sympathetic nervous system, bone loss medications (such as Actonel), and antidepressants Physical or occupational therapy
Applications of heat and cold
The use of a TENS (trancutaneous electrical nerve stimulator) unit
Biofeedback 
Nerve blocks (injecting medicine to numb the affected nerves or pain fibers around the spinal column)
Surgical sympathetomy (radical surgery that involves cutting the nerves to destroy the pain, but other sensations may be destroyed as well)

The outlook is better with an early diagnosis. If the condition is recognized within the first stage, sometimes it may go into remission and normal movement will be possible with minimal changes. However, if it is not diagnosed quickly, deteriorating changes in the bone and muscle may develop rapidly and become irreversible.

Complications
When the disease progresses, the complications include further deterioration of the affected limb, or the spread of the disease to another part of the body. In addition, there are possible complications associated with some of the nerve and surgical treatments.

You should contact your health care provider if you develop constant, burning pain in an arm, leg, hand, or foot. CRPS is a difficult disorder to treat and is a diagnosis of exclusion. However with aggressive physical therapy and medical management, a decrease in the pain intensity and functional improvement can occur.