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Complex regional pain syndrome

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What is complex regional pain syndrome (CRPS)?

Most Injuries heal by itself. Sometimes post-injury pain may remain for more than 3 months and is associated with swelling, redness and skin changes. this is called Complex regional pain syndrome or CRPS. This is also called as Reflex sympathetic syndrome or RSD.

CRPS may also develop after surgery, a heart attack, a stroke or other medical problem.

The pain may be burning sensation and is out of proportion to what is expected for the injury.

Symptoms include –

  • “Burning” pain in your arm, leg, hand or foot.
  • Skin sensitivity.
  • Some other features are changes in skin temperature, color and texture. Skin may be sweaty, cold or warm than normal. Skin color changes are also commonly seen and may be white or mottled to red or blue. Skin is hypersensitive (allodynia) sensitive to touch, gush of air, movements may be painful. Skin may be thin or shiny in the affected area.
  • There are changes in hair and nail growth.
  • We also see joint stiffness, swelling and damage. Along with these muscle spasms, weakness and  muscle loss (atrophy) is also seen.

CRPS can be :

  • Type I (RSD) – No direct injury to nerves
  • Type II (Causalgia) – following a distinct nerve injury.


Early treatments may provide dramatic relief. Best approach is a combination of various treatments. Treatment options include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) – relieve pain and inflammation
  • Antidepressants and anticonvulsants – for pain coming from a damaged nerve (neuropathic pain)
  • Corticosteroids – may reduce inflammation. Y
  • Alendronate and calcitonin
  • Opioid medications for severe pain


  • Applying heat and cold
  • Topical analgesics
  • Physical therapy
  • Sympathetic nerve-blocking medication
  • Biofeedback. In some cases, learning biofeedback techniques may help. In biofeedback, you learn to become more aware of your body so that you can relax your body and relieve pain.
  • Spinal cord stimulation

Lower Back Pain Symptoms – What are they?

Diagnostic Injections in the spine can be done to establish the cause of your pain. Few tests done are –

  • Selective root or transforaminal Epidural steroid injections,
  • facet joint or its nerve block, if positive then treated by radiofrequency ablation (RFA)
  • Provocative discography, and if its positive than treated with Percutaneous Disc FX Discectomy, Dekompressor / ozone discectomy, Percutaneous endoscopic transforaminal discectomy.

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