CRPS Pain Syndrome, Reflex Dystrophy 3.5/5 (22)

Last updated: 4 / 03 / 21
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CRPS

CRPS pain syndrome / Reflex dystrophy / algodystrophy with pain, swelling and thin, shiny skin. Patient Association CRPS https://commons.wikimedia.org. CC BY SA 3.0

CRPS (Complex Regional Pain Syndrome) ICD-10: M89.0

Definition

CRPS - pain syndrome is characterized by the fact that even a small physical injury can cause great, chronic pain and other symptoms. CRPS is a neurological condition that can be divided into two types:

  • Type I; Reflex dystrophy, Algodystrophy, Sudeck's atrophy
  • Type II: Causalgia. Most often after nerve damage

Symptoms of CRPS pain syndrome

  • Chronic major pain
  • Swelling
  • Skin symptoms
  • In the first stage, the injured arm or leg is very painful, hot in the skin, reddish and swollen.
  • At a later stage, the arm or leg becomes cold, numb or numb. The swelling goes back. Some people develop pain in the opposite arm / leg.

Diagnosis

Diagnostic criteria for CRPS according to The International Association for the Study of Pain (IASP) . (Type I and II are quite similar):

Type I

  1. There is a triggering injury or immobilization
  2. Persistent pain or hypersensitivity (hyperalgesia)
  3. Swelling (edema), skin changes with signs of altered blood circulation to the skin or abnormal sweating in the painful area
  4. No other conditions that can explain the degree of pain and the reduced function

Type II (causalgia)

  1. Persistent pain or hypersensitivity after a nerve injury, but not necessarily limited to the nerve supply area
  2. Swelling (edema), skin changes with signs of altered blood circulation in the skin or abnormal perspiration in the painful area.
  3. No other conditions that can explain the degree of pain and the reduced function

CRPS pain syndrome in the left hand. Smooth, swollen skin and increased hair growth. Sunder RA, J Brachial Plex Peripheral Nerve Inj (2008). CC BY 2.0

Supplementary medical investigations

  • Thermography
  • Radiological examinations (MR, Scintigraphy, Dexa measurement of bone mass)
  • Neurography, Electromyography (EMG)

Incorrect diagnosis, similar conditions, differential diagnoses

  • Blood clot / thrombosis (by Antifosfolipid syndrome and other disposable conditions)
    • No pain
  • RS3PE
    • Both hands swollen
    • High CRP and ESR in blood samples
    • Older people
  • Nervous system disorders
    • Kidney damage, plexus injury and more)
  • Fracture injury (fracture)

Treatment

Unfortunately, often disappointing results.

  • Medication
  • Physiotherapy
  • Psychological measures

Prognosis

The condition lasts for several months. Some people have symptoms for more than five years. 

Literature

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