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5 Tips for Dealing with Complex Regional Pain Syndrome

Have you received a complex regional pain syndrome (CRPS) diagnosis? Are you struggling with extreme pain that makes it hard to perform day-to-day activities?

Being able to cope with the illness is critical for maintaining your overall health. Although it can be difficult to make the pain go away, there are ways to manage the pain and our team can help.

What Is Complex Regional Pain Syndrome (CRPS)?

Complex regional pain syndrome is a chronic neuropathic condition that causes severe and debilitating pain. It usually affects just one arm or leg, but it can spread to other parts of the body. Although most cases of CRPS result from an earlier injury, the pain that results from it is a lot more serious and longer-lasting than normal.

There are two types of CRPS:

  • CRPS type 1: This type of CRPS is also known as reflex sympathetic dystrophy (RSD) or Sudeck's syndrome. CRPS type 1 often results from an injury, such as a fracture or sprain. Patients with CRPS type 1 don’t suffer nerve damage.
  • CRPS type 2: Often called causalgia, CRPS type 2 occurs after damage to a nerve in the limb.

In someone suffering from CRPS, the affected limb is often so sensitive that the slightest touch, bump, or even change in temperature can cause excruciating pain. Patients might also experience swelling, stiffness, and changes in color and temperature in the affected limb.

Anyone can get CRPS, including children. The illness most commonly affects the hands, wrist, foot, ankle, or knee. In some cases, it can affect the entire limb.

Most CRPS patients will experience what’s called a CRPS flare up. When this occurs, the patient experiences a spike or increase in their pain and other symptoms.

There are various causes of CRPS flare ups, including:

  • Stress
  • Fatigue
  • Cold or heat
  • Emotional or physical trauma
  • Weather changes (i.e. barometric pressure)
  • Too much, or not enough physical activity
  • Inflammation

There are three stages of CRPS:

  • Stage 1 (Acute dysfunction phase): Burning pain, joint stiffness, increased sensitivity, temperature changes in the skin (warmer).
  • Stage 2 (Dystrophy): Hypersensitivity, muscle weakness, bone mass reduction
  • Stage 3 (Atrophy): Osteoporosis, functional impairment, temperature changes in the skin (cooler).

What Are the Symptoms of CRPS?

  • Constant burning or throbbing pain, usually in the arm, leg, hand, or foot
  • Pain that spreads (i.e. pain from an injury to a finger or toe spreads to your entire arm or leg)
  • Sensitivity to touch and cold
  • Swelling and stiffness of the affected limb
  • Changes in skin temperature, texture, and color
  • Impaired muscle strength and movement
  • Changes in hair and nail growth
  • Muscle spasms, tremors, weakness, and loss (atrophy)

Symptoms may extend beyond physical changes. People suffering from CRPS may suffer from mental and emotional stress from dealing with chronic pain. For example, they may become depressed or anxious. Patients dealing with CRPS might also contemplate suicide, especially during periods of extreme pain.

What Causes CRPS?

In over 90% of CRPS cases, injury to a limb causes damage to the nerves that transmit pain, itch, and temperature sensations.

The most common causes of CRPS include:

  • Fractures
  • Surgery
  • Sprains/strains
  • Burns or cuts
  • Poor circulation
  • Poor nerve health
  • Stroke

Heart attack

Can You Prevent CRPS?

Unfortunately, no one really understands the processes of CRPS. Therefore, there’s no way to predict or prevent the condition. However, detecting the illness early is key to helping you and your healthcare providers start early management to prevent any new problems from developing.

However, because we know that injuries are the most common cause of CRPS, there are a few things you can do to prevent it. For example, you can take vitamin C after a wrist fracture. According to some studies, people who take a high dose of vitamin C after a risk fracture may have a lower risk of CRPS than those who didn’t take vitamin C.

How Do Physicians Usually Diagnose CRPS?

There’s no specific test to diagnose CRPS. Instead, physicians usually diagnose CRPS through careful history, physical examination, and review of your symptoms.

However, certain tests may help your doctor confirm CRPS and rule out other illnesses. These tests include:

Bone scan. Because CRPS can cause changes in the bones, a bone scan may help reveal if the bones in the affected area have grown smaller in size or have disintegrated.

Sweat production tests: Measure how much a patient sweats during physical activity or other stimulation. Because CRPS often causes dysfunction in sweat production, an abnormal result on a sweat production test can be an indicator of the condition.

X-Rays: Can detect loss of mineral from your bones on an X-Ray in later stages of the disease.

Magnetic resonance imaging (MRI): Images from an MRI test may show tissue changes that rule out other conditions.

What Can a Physical Therapist Do To Help CRPS?

There are many treatments patients can try to manage CRPS. These include:

  • Pain relievers: Over-the-counter (OTC) pain relievers, such as Tylenol, Ibuprofen, Aleve, Advil, and others can provide temporary pain relief
  • Antidepressants and anticonvulsants: Can treat pain from a damaged nerve
  • Corticosteroids: Steroid medications that can reduce inflammation and improve mobility.
  • Bone-loss medications. Medication that can prevent or slow bone loss.
  • Intravenous ketamine: A strong anesthetic that may significantly reduce pain.

Aside from these treatments, physical therapy can also help treat the pain of CRPS. Typically, physical therapy to manage CRPS symptoms includes:

  • Movement therapy
  • Desensitization
  • Edema management
  • Range of motion exercises
  • Stretching
  • TENS (transcutaneous electrical nerve stimulation)
  • Mirror therapy

5 Tips for Coping With CRPS or Chronic Pain

CRPS can be very debilitating. As a result, it can cause significant emotional distress that affects normal daily functioning. Fortunately, there are a few things you can do to manage and cope with the pain.

1. Practice Relaxation Techniques

When you have a CRPS flare up, try some relaxation techniques to help you stay calm during intense periods of pain. Staying calm will also help slow down your nervous system, which will likely be in overdrive due to your chronic pain.

If you’re experiencing intense pain, your heart is likely beating rapidly, and it’s likely that your body is in the fight-or-flight response. This releases stress hormones such as cortisol and adrenaline, which only serve to make your pain and symptoms worse.

To counteract this response, try to calm down and meditate. When you’re in excruciating pain that won’t go away, go to your bedroom, and turn off the lights. Lie down, and try to relax. Start some deep breathing exercises. Meditate. Visualize yourself somewhere that makes you happy.

While relaxation won’t make the pain go away, it can alleviate it and help you cope.

2. Find a Support Group

Support groups can be helpful for people with CRPS who want to connect with others battling the condition. For example, being able to connect with others can help you learn new ways to cope,

You can also find online communities where people with CRPS converse and share their experiences with the illness. For example, the Burning Nights FORUM or social media groups can be helpful resources for people with CRPS.

3. Use a TENS Unit

Transcutaneous electrical nerve stimulation (TENS) uses low-voltage electrical current to stimulate the nerves in the affected area. The electrical currents send signals to the brain that inhibit the normal pain signals.

Another benefit of using a TENS unit is that it’s portable and you’re able to wear it on any part of the body.

4. Look for Distractions

Because it’s difficult to stop the pain from CRPS, it”s best to find ways to distract yourself when there’s a severe flare up. While you wait for the medication to work, you can try:

  • Painting
  • Drawing
  • Writing
  • Listening to music
  • Exercising
  • Walking

Having a good distraction can play a significant role in how you cope with pain from CRPS.

5. Try Biofeedback

Biofeedback is a non-drug intervention that treats patients with CRPS. To understand what biofeedback means, it helps to break the word down into two parts: “bio”, referring to the body and “feedback” receiving information about the body.

Biofeedback is a mind-body therapy in which a physical therapist attaches sensors to your body to measure different body functions such as brain wave activity, sweat glands, heart rate, muscle tension, and skin temperature.

Through these sensors, you can receive information about your body to help you make certain changes to the way your body functions. These changes include relaxing certain muscles to achieve the results you want, such as reducing pain.

Are you struggling with debilitating pain due to CRPS? At AmeriCare Physical Therapy, we can help you manage that pain with our extensive services. Book an appointment with us today.

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