What is Complex Regional Pain Syndrome (CRPS)?
Complex regional pain syndrome (also known as complex regional pain disease) is a condition where a patient experiences severe pain after a major injury or medical event, such as surgery, trauma, stroke, or heart attack. Complex regional pain syndrome can occur anywhere on the body but is usually found in the limb or area where the injury happened.
CRPS can affect people of all ages, including children. It is often seen in those who have had surgery, suffered traumatic injuries, or experienced a stroke, with adolescent girls being the most commonly affected group. Studies suggest that 1-2% of individuals who experience a limb injury or surgery might develop CRPS. While the exact cause of CRPS is not fully understood, it is believed to result from a combination of issues in the nervous system, immune system, and genetic factors.
What are Symptoms of Complex Regional Pain Syndrome?
CRPS usually causes pain that lasts longer than expected after an injury, illness, or medical event. The pain can be located in the affected limb or spread throughout the body. In some cases, CRPS might even move from the initial area to other parts of the body. Each person’s symptoms can be different, but CRPS is often diagnosed as one of the following types:
- CRPS-1: Patients experience pain after an injury or illness, but symptoms are not associated with specific nerve damage.
- CRPS-2: Patients experience painful symptoms associated with a specific nerve.
Patients with CRPS can experience pain that makes it difficult to accomplish everyday tasks, like attending school, physical exercise, and other activities. Besides pain, other CRPS symptoms often include:
- Swelling and sensitivity in the affected area
- Changes in skin temperature and color in the affected area
- Changes in hair and nail growth
- Joint stiffness and swelling
- Muscle spasms and weakness
- Trouble moving the affected body part
How is Complex Regional Pain Syndrome Diagnosed?
The duration and severity of CRPS can vary greatly from person to person. For some, symptoms may improve or go away over time. However, in other cases, the condition can continue for months or even years. At Rady Children’s, our dedicated pain specialists will work with your family to determine the severity of the patient’s symptoms, their full medical history, and a treatment plan forward. In all cases, early intervention is the best path forward to a full recovery, which is why it’s essential to bring your child to a specialist if they present with any of the symptoms.
At Rady Children’s, the diagnostic process for CRPS involves a multi-faceted approach. As there is no specific test for the condition, our pain specialists will perform a health exam and review the patient’s family health history. Often, they will order additional procedures including:
- X-rays
- Blood test
- MRI
What are Treatment Options for Complex Regional Pain Syndrome?
If your child is diagnosed with CRPS, it’s important to remember that you have options. We want to help your child return to function and thrive. The Rady Children’s Chronic Pain Clinic provides an interdisciplinary approach that emphasizes the mind alongside the body. Children and teens work closely with our medical professionals to develop their own strategies so they can return to school, sports, and their social life. The following therapies are used for this purpose:
- Physical therapy
- Occupational therapy
- Cognitive behavioral therapy
- Symptomatic pain management
For patients requiring intensive care, the Rady Children’s Inpatient Chronic Pain Management Program is available. It is a 28-day inpatient program for children, adolescents, and young adults — typically ages 11 to 21 — with chronic pain who continue to have significant pain and dysfunction despite trying various outpatient therapies. It’s also an opioid- and pain medication-free program, which many families find helpful in the face of current medication challenges.
How Does Rady Children’s Help Manage and Support Patients with CRPS?
Dealing with CRPS can be tough, both for the patient and their family. The diagnosis process and recovery can be stressful. To help with this, Rady Children’s provides family counseling and resources to support everyone involved. Children with CRPS often need extra help at school and in social situations. They might miss classes for medical appointments and need more time to complete assignments and tests.
Even with these challenges, it’s important for your child to stay active in school and extracurricular activities and keep in touch with friends. Exercise can help with symptoms, but your child might need extra support during gym class and may need to limit their activity because of pain. Always check in with your child about how they’re feeling and adjust their schedule and activities as needed.
At Rady Children’s, we are committed to providing the necessary support and resources to help children and their families navigate the challenges of this condition. To learn more about the services we provide, contact us.
Sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4850724/
https://www.rchsd.org/programs-services/chronic-pain-programs/inpatient-chronic-pain-program/