Complex Regional Pain Syndrome (CRPS)

What is Complex Regional Pain Syndrome?

Also known as Reflexive Sympathetic Dystrophy, it is a chronic neurological syndrome characterized by:

• Severe burning pain
• Impaired movement
• Changes in bone/skin
• Changes in hair and nail growth
• Excessive sweating
• Skin color changes (red,blue, blotchy, or white)
• Tissue swelling
• Sensitivity to touch or cold
• Muscle spasms/tremors

CRPS development does not appear to depend on the magnitude of the injury. The sympathetic nervous system, our control center for the fight or flight response, seems to assume an abnormal function after an injury.

Are there multiple types of Complex Regional Pain Syndrome?

YES, CRPS type I (also known as RDS, approximately 90% of all CRPS) -Cases in which the nerve injury cannot be immediately identified or there isn’t a specific nerve injury. Example: immobilization, fracture, sprain, or other soft tissue injury.

CRPS Type II (also known as Causalgia) -Cases in which a distinct/direct nerve injury has occured.

How will my doctor know if I have Complex Regional Pain Syndrome?

Since there is no laboratory test to diagnose CRPS, the physician must assess and document both subjective complaints (medical history) and objective findings (physical examination).

How will physical therapy help me with my pain?

Physical therapy will assist in reducing your pain, improving range of motion, and improve daily functional use of the affected area. We will also teach you how to be independent in managing your symptoms.

I have had physical therapy before. How will it be different with Lifestyle Physical Therapy?

We approach treatment of this condition in a relatively new way with use of the following:

• Limb Recognition: Ensuring the brain can differentiate right and left. This is frequently impaired with chronic CRPS.
• Explicit motor imagery: thinking about moving or touching the limb without actually moving the limb.
• Mirror therapy: using direct line of site mirror images of the limb with a tablet or virtual reality headset we can often show the brain pain free touch and or movement.
• Desensitization: retaining the painful area to accept touch, movement, and pressure.
• Functional Training: exercise designed specifically to help patients return to their regular lifestyle.
• Most importantly, all treatment will be performed with the goal of not increasing pain.

How long will I have to attend physical therapy?

The length of time a patient requires physical therapy treatment is variable. Typically, the worse the pain or longer the pain has been present the longer the course of treatment. Treatment may be as short as 4 weeks up to multiple months. The usual treatment is 2-3 times a week for 30-60 minutes.

Will my insurance cover this type of treatment?

Yes, this will be covered as an outpatient physical therapy service. A referral may be needed from your doctor.

What else can I do to assist in my recovery?

Proper sleep, nutrition, and hydration while managing stress as much as possible are very important to recover optimally.

For more information: www.rsds.org or www.noigroup.com

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