Complex Regional Pain Syndrome explained; do you have it?

FEATURE — Complex Regional Pain Syndrome is a form of chronic pain caused by debilitating neuropathic disease. It often starts after a traumatic injury or surgery and the pain is out of proportion to the original injury. Symptoms include abnormal hair and nail growth, swelling, temperature changes, color changes of the skin, weakness, decreased range of motion, sensitivity to touch and intense burning pain at the affected site.

There are two major factors associated with CRPS.

The first factor is what’s known as hyperalgesia, which is extreme sensitivity to normally semipainful stimuli, like being pinched. Being pinched is painful but usually for only a short period of time. This sensation would cause prolonged, intense pain in a patient with CRPS.

The second factor of CRPS is called allodynia. Allodynia is pain caused by something that normally would not cause pain, like a bed sheet brushing over the skin. Some patients who have CRPS might experience an intense burning pain or discomfort.

Medical literature suggests the earlier diagnosis and treatment occurs, the better the outcome can be. Although there is no cure for CRPS, the patient has multiple options such as active mobilization physical therapy, pharmacological therapy, sympathetic nerve blocks and possible spinal cord stimulation.

A surgeon or primary care physician would likely start a CRPS patient with physical therapy and some type of medication as treatment. If these remedies fail to address the problem, a referral to a pain management center may be arranged for sympathetic nerve blocks or to consider a spinal cord stimulator.

Providers use various types of medications to treat CRPS. Various over-the-counter medications, such as Tylenol, ibuprofen or naproxen, are often used for pain and inflammation. Prescription-strength pain relievers or antidepressants, such as amitriptyline and cymbalta, can also be considered, as well as anticonvulsants, such as gabapentin, which can help with nerve pain.

Sympathetic nerve blocks target a group of nerves that are part of the autonomous nervous system. These spread to your body and help with involuntary function. This procedure is done in a series of injections under fluoroscopy (live x-ray), and medication is injected to help reduce the pain. These injections may be repeated if and when the CRPS symptoms return or worsen.

A spinal cord stimulator is a device that is surgically implanted to help lessen the intensity of pain. This is done by placing small electrodes in the spinal canal region to help lessen the pain signal traveling from the affected limb to the sensors in the brain. Rather than feeling pain, the patient typically feels a tingling sensation.

Prior to having the permanent device placed, a 4-5 day trial would be performed. This is done as an office procedure in a fluoroscopy suite at a pain management office. During the trial period, 50 percent improvement is needed to proceed with permanent placement.

Dealing with chronic pain can be frustrating for our physical and mental health. If you feel like you may suffer from CRPS, talk with your health care provider to begin diagnosis.

author_cortneyWritten by Cortney Bernardo for St. George Health and Wellness magazine and St. George News.

Cortney Bernardo grew up in Circleville, Utah, where she graduated from Piute High School. She then went on to Southern Utah University where she received a bachelor’s degree in Biology with honors and was accepted to Pacific University in Forest Grove, Oregon. She graduated with honors as a physician assistant with a master’s degree in science.

Cortney is married to her high school sweetheart, and they have two beautiful daughters. They have resided in St. George since she finished her schooling. She enjoys spending time with her family and friends, swimming, running, reading and doing Crossfit.

 

 

St. George Health and Wellness website

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Copyright St. George News, SaintGeorgeUtah.com LLC, 2015, all rights reserved.

 

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5 Comments

  • beentheredonethat December 26, 2015 at 10:51 pm

    This is an important medical discovery/breakthrough. More reasons for Utah doctors to give out pain killers. Not just ptsd anymore. What a joke!

    • Heather December 27, 2015 at 9:16 pm

      I really hope you’re not calling CRPS/RSD a joke.
      I’ve had it for 4 years now and it’s absolute hell. Literally. A doctor at Johns Hopkins has stated “If Hell was a Disease, it would be Reflex Sympathetic Dystrophy” (which is aka CRPS).
      It’s recorded to be the most painful health condition known to mankind. The pain is ranked higher then getting a finger amputated without anesthesia.
      So if you consider this a joke, then you have a screw loose. I developed it at age 24, and now I’m unable to work, dependent on my parents (for the first time since I was 14), and have had so much of my life taken away from me.

      Research the things you comment on, before you offend others due to your ignorance.

      To the author, thank you for helping to spread awareness 🙂
      -Heather Lynn

    • ladybugavenger December 28, 2015 at 12:55 pm

      I bet marijuana would help! Legalize Marijuana!

  • .... December 28, 2015 at 9:45 am

    Whaaaaaaaaaaa whaaaaaaaaaaa jeez what a cry baby. Its all in your head you just want attention

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