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Complex Regional Pain Syndrome, previously known as Reflex Sympathetic Dystrophy, is a severe neuro-inflammatory pain disorder,  usually after a trauma such as a broken bone, musculoskeletal injury, nerve damage, or surgery. Immobilization may be a risk factor for CRPS. Usually beginning in one extremity, symptoms do not follow nerve distribution patterns, but are regional. Many CRPS patients experience insomnia, fatigue, and depression. 

 CRPS is divided into Type 1 with no  demonstrable nerve injury and Type 2 with  nerve injury. Treatment is the same for both. Research conducted by Anne Oaklander, MD, PhD has shown that small fiber pathology exists even in Type 1.  A concept which has fallen out of favor is the  Stages of CRPS.  Symptoms may wax and wane. Acute and chronic CRPS symptoms may vary in presentation.

Many people diagnosed with CRPS recover within the first year. However some people experience chronic, unrelenting severe pain and disability.  Over time, symptoms can spread beyond the initially affected area. Long standing CPRS may result in systemic complications.

Symptoms include:

•  Ongoing severe pain which can be described as burning, squeezing,  prickly pins and needles, or throbbing
• Swelling which can be excessive
• Color and temperature changes such as heat with redness and/or blue with coldness or blotchy, purple or pale skin
• Allodynia - heightened sensitivity to stimulation that doesn't normally cause pain
• Hyperalgesia - painful stimulation causes more pain than usual
• Abnormal sweating
• Skin, hair and nail changes
• Stiffness and limited range of motion
• Muscle spasm, tremor, or dystonia (muscle contractions causing fixed abnormal position of limb)
• Muscle Atrophy

Damage to or malfunction of the peripheral and central nervous system is believed to be at the root of the condition. Changes in blood flow and high levels of immune system inflammatory agents contribute to the symptoms. 

It is important to begin treatment as soon as possible, while only the peripheral nervous system is affected and before there are changes to the central nervous system (brain and spinal cord).

CRPS is diagnosed based on clinical signs observed by the physician, and symptoms reported by the patient using the IASP Budapest Guidelines. Other conditions with similar symptoms must be ruled out.

 It's important to make sure your physician is qualified to diagnose and/or treat CRPS. It's estimated that the average patient see more than four doctors before they receive a proper diagnosis. 

For information about treatment options, research, and more, please visit our "Where can I get more information" section.