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Above: Assessing postural alignment to pinpoint the cause of lowerback painWhat is complex regional pain syndrome (CRPS)?
Complex regional pain syndrome (CRPS) is a long term condition that causes chronic burning pain in one of the limbs along with swelling and skin problems. CRPS often occurs in one of the hands, arms, feet or legs. Common features of CRPS include dramatic changes in temperature and colour of the skin over the affected region of the body, along with sensitive skin, intense burning pain, swelling and sweating.
Mild CRPS can be quite common and with successful rehabilitation it may resolve itself within a few weeks or months. More severe CRPS can last for a very long time and may be significantly disabling and have a debilitating impact on the everyday life of the sufferer.
Above: Physiotherapist demonstrating mobilisation technique to reduce upper back painWhat causes complex regional pain syndrome (CRPS)?
It is still relatively unknown what causes CRPS but several factors have been thought to contribute to its onset. Common factors that are believed to trigger the development of CRPS include trauma resulting in fracture or injury and multiple limb operations (body tissue and bone damage). Although these incidents can occur without adverse complications, in some cases people may go on to develop CRPS. There are some cases of CRPS where there has been no original trauma or injury.
Additionally, it is believed that the development of CRPS involves the disruption of communication pathways between the affected limb and the brain.
A special group of nerve fibres called the sympathetic nervous system is also deemed to be a major contributor to CRPS. The sympathetic nervous system controls regulation of blood flow and skin temperature which can both be affected in CRPS cases.
Above: Soft tissue massage to alleviate symptoms of aching and painThere are two types of CRPS:
- Type 1 – is initiated by trivial injuries where no nerve damage has occurred such as minor broken bones or sprained joints
- Type 2 - is caused by more severe injuries where damage to the nerves has taken place such as a broken bone, a major limb operation or from a serious infection.
What symptoms will you have?
The main symptom of CRPS is pain around the affected area. Other symptoms include:
- Intense "burning" pain in affected limb
- Skin temperature alterations: warmer or cooler compared to the opposite extremity
- Skin colour changes: can be blotchy, pale, red or purple
- Increased skin sensitivity
- Changes in skin texture: shiny and thin, and sometimes excessively sweaty
- Disruption of normal nail and hair growth patterns
- Swelling and stiffness in affected joints
- Reduced ability to move the affected body part
What physiotherapy treatment is available for complex regional pain syndrome (CRPS)?
Physiotherapy is a very effective method of treatment that aims to reduce your pain and restore as much function in your affected limb as possible using a variety of activities. Physio.co.uk has specialist physiotherapists that will provide you with a thorough assessment and a comprehensive rehabilitation programme that is specific to you. The interventions included in your physiotherapy programme aim to focus on treating and improving the problems you are experiencing as a result of complex regional pain syndrome. Your physiotherapy will include:
- Pain modalities
- Heat orcryotherapy (ice) – for muscle and joint pain
- Stress management and relaxation techniques
- Massage
- Acupuncture
- Electrical stimulation
- Hydrotherapy
- Gradual exercise to keep the painful limb or body part moving
- Stretching of affected joints to maintain or improve range of movement
- Some gentle progressive strengthening exercises to restore strength in the affected muscles and joints
- Functional activities and exercises to help problems associated with daily living
- Education on how to make lifestyle changes that may affect your condition – advice on diet, managing sleep and managing rest
Summary
Complex regional pain syndrome (CRPS) is a chronic and progressive pain condition which is characterised primarily by a burning pain in a certain body part but mainly affects limbs. The cause of CRPS is relatively unknown but is thought to be caused by the sympathetic nervous system or a disruption is communication between the brain and the affected limb. Additionally CRPS is believed to result for some form of bodily damage including broken bones, sprained ankles and infection. Other symptoms of CRPS include skin sensitivity, alterations in skin colour, abnormal temperature changes, swelling and spontaneous sweating all in the affected area. Physiotherapy is effective as it offers a variety of treatment strategies that aim to reduce symptoms which are associated with complex regional pain syndrome. Specialist physiotherapists at Physio.co.uk aim to control pain and maintain or improve as much mobility and function in the affected limb so as to get you back doing whatever it is you love doing the most as quickly as possible. Call Physio.co.uk now on 0330 088 7800 for more information or to book an appointment please contact us. You can also book online today!
