Complex Regional Pain Syndrome (CRPS) is a chronic condition affecting the limbs after surgery, an injury, or trauma. Doctors do not know th exact cause of CRPS. However, it involves abnormal responses from your nervous system. This results in prolonged and intense pain that is out of proportion to the initial injury.

The condition can lead to a range of distressing symptoms. They include burning pain, sensitivity to touch, swelling, temperature changes, and reduced mobility. Factors like age, genetics, and poor blood circulation can increase your risk of developing the condition. Without proper treatment, CRPS can severely impact your ability to perform daily activities and your quality of life.

Different treatment options are available for the condition. They include medication, spinal stimulation, and physical therapy. If you seek physical therapy for your CRPS in Las Vegas, NV, you will need our expert services at Suarez Physical Therapy.

What is Complex Regional Pain Syndrome?

Complex Regional Pain Syndrome is a condition that causes ongoing pain. It usually develops after an injury, but the pain continues even after the body has healed. The pain can be severe, spreading, and disabling. CRPS often affects a single limb, such as a hand, leg, arm, or foot. In some cases, it may spread to other parts of the body. The pain associated with this condition may be worse than that of the original injury. There are two types of CRPS:

  • Type I. This type occurs without clear nerve damage. It is also called Reflex Sympathetic Dystrophy (RSD).
  • Type II. This type occurs with confirmed nerve injuries.

Both types of CRPS cause similar symptoms, and the difference lies in whether doctors can identify a damaged nerve. CRPS impacts about 5 to 26 people per 100,000 each year. It is more common in women than in men. Most cases appear between 40 and 60, but can affect anyone, including children.

Compared to other pain conditions, CRPS often includes problems with the skin, blood vessels, muscles, and bones. There is no single test to diagnose complex regional pain syndrome. Diagnosis depends on symptoms and ruling out other conditions. For this reason, CRPS is challenging to recognize early.

Signs and Symptoms of Complex Regional Syndrome

The signs and symptoms of CRPS can vary from person to person and may change over time. However, most people with the condition experience some or all of the following:

  • Ongoing, severe pain. The most common symptom is continuous pain. It is usually burning, throbbing, or stabbing. The pain often feels much worse than expected from the original injury. It can spread beyond the initial area.
  • Sensitivity to touch and temperature. Many people with CRPS cannot tolerate even light touch. Something as gentle as clothing or a breeze can cause sharp pain. The affected area may also become very sensitive to cold or heat.
  • Swelling and inflammation. Swelling may occur around the injured area. It can come and go or remain constant. The skin may feel warm or look red during a flare-up.
  • Changes in skin color, texture, and temperature. The skin of a person with complex regional pain syndrome may turn pale, blotchy, blue, or shiny. It might feel unusually cold or hot. In some cases, the texture becomes thin, dry, or sweaty.
  • Joint stiffness and reduced mobility. Joints in the affected area may become stiff or hard to move. This is often due to pain, swelling, or muscle weakness. In serious cases, muscles can waste away from lack of use.
  • Abnormal nail and hair growth. CRPS may cause hair to grow faster or slower. Nails might become brittle, thick, or grooved.
  • Muscle spasms or tremors. Some people with CRPS experience muscle cramps, jerking movements, or shaking in the affected limb.
  • Emotional symptoms. Chronic pain can lead to anxiety, depression, and sleep problems. Many people with CRPS feel frustrated, isolated, or misunderstood.
  • Spreading of symptoms. Although CRPS usually starts in one limb, it can spread. Sometimes it moves to the opposite limb or unrelated parts of the body.
  • CRPS symptoms often come in cycles. They may get worse with stress, weather changes, or physical activity. Without treatment, the condition can become more severe and harder to manage.

Causes and Risk Factors of Complex Regional Pain Syndrome

The exact cause of CRPS is not fully understood. However, experts believe it involves problems in the nervous system. The body responds to an injury abnormally and exaggeratedly. CRPS often begins after an injury. The injuries could include a broken bone, sprain, burn, or surgery. The injury heals normally in most people, but in CRPS, the pain continues long after healing. The following factors can increase the risk of developing CRPS:

  • Injury or trauma. An injury is the most common trigger. CRPS often begins after a fracture, surgery, or even a small cut or bruise.
  • Nerve damage. In some people, injury to a specific nerve causes abnormal pain signals. These signals may confuse the brain and lead to CRPS.
  • Poor blood circulation. Problems with blood vessels can cause swelling, temperature changes, and color changes in the skin, which play a role in CRPS symptoms.
  • Inflammation and immune response. Some research shows that CRPS may involve the immune system. Inflammation may affect nerves and tissues, leading to pain and swelling.
  • Genetics. CRPS may run in families. Some people may be genetically more sensitive to pain or inflammation.
  • Psychological factors. Stress, anxiety, and past trauma can make pain worse. These factors do not cause CRPS but may affect how it develops or becomes severe.
  • Age and gender. CRPS is more common in women than men. It affects people between the ages of 40 and 60. However, children and teenagers can also develop the condition.

Diagnosis of CRPS

There is no single test that confirms CRPS, which makes its diagnosis challenging. Doctors must rely on symptoms, medical history, and physical exams. Many people go through several tests before getting a diagnosis. Early diagnosis is key to better outcomes.

Doctors usually begin by asking about your pain and past injuries. They will check how the skin looks and feels. Swelling, temperature changes, and sensitivity are essential clues. To help with diagnosis, doctors often use the Budapest Criteria. This is a list of signs and symptoms that must be present. They include:

  • Ongoing pain that is out of proportion to any injury
  • At least one symptom in each of four categories: sensory, vasomotor, sudomotor/edema, and motor/trophic
  • At least one sign during the physical exam in at least two of these categories
  • No other condition better explains the symptoms

A process of elimination often diagnoses CRPS. Doctors must rule out infections, arthritis, nerve compression, and other causes of pain. These may include:

  • Bone scans. These can show changes in the affected area's blood flow and bone metabolism.
  • This test gives detailed pictures of tissues and can detect changes in soft tissue or bone.
  • X-rays. In later stages of CRPS, X-rays may show bone thinning or damage.
  • This test measures skin temperature and blood flow. It can reveal uneven heat patterns between limbs.
  • Nerve conduction studies. These tests check how well the nerves are working. They can show whether there is nerve damage.

Treatment Options for Complex Regional Pain Syndrome

There is no definitive treatment for CRPS, which makes it challenging to treat. However, most individuals get better with an appropriate combination of treatments. Outcomes are generally more favorable with early intervention. Some common ways to treat the condition are:

Medications

Several types of medications may help manage the symptoms of CRPS. They include:

  • Pain relievers. Over-the-counter drugs like ibuprofen or naproxen can reduce pain and inflammation in the early stages.
  • Some antidepressants, like amitriptyline, help relieve nerve pain.
  • Medications like gabapentin and pregabalin calm nerve activity and reduce pain signals.
  • Corticosteroids. These drugs lower inflammation and may help in the early phase.
  • Bone loss medications. Drugs like bisphosphonates can help if bones are weakening.
  • Topical creams. Lidocaine or capsaicin creams may numb the skin and reduce pain locally.
  • In severe cases, your doctor may prescribe opioids. However, they are not a long-term solution.

Nerve Blocks and Injections

Physicians may perform nerve blocks, where numbing medication is placed around specific nerves. This prevents pain signals from reaching the brain, which can be quite relieving. The most commonly performed are sympathetic nerve blocks. It works by targeting the sympathetic nervous system.

These blocks could lead to a more free-moving limb and less rigid muscle tone. In some cases, this requires repeat injections to be longer-lasting. They are frequently incorporated into a larger plan of pain relief.

Spinal Cord Stimulation (SCS)

Doctors recommend spinal cord stimulation for people who do not respond to more conservative treatments. It involves implanting a small device under the skin near the spine. The device sends mild electrical pulses to the spinal cord. These signals interrupt the pain messages before they reach the brain, relieving pain.

Patients often undergo a trial period first to see if SCS helps. If it works well, a permanent device is implanted. The device is adjustable with a remote control to match the level of pain relief needed.

Mental Health Support

CRPS can take an equally emotional toll on your well-being. Depression, anxiety, and emotional fatigue are common results of chronic pain. Patients may find comfort in talking with a counselor, therapist, or psychologist. Support for mental health is a key aspect of healing and managing pain.

Complementary Therapies

Some people turn to alternative treatments such as acupuncture, massage therapy, or chiropractic treatment. They can assist with pain relief, circulation, relaxation, etc. While results are mixed, it can lead to improved overall comfort and can be supportive of regular care.

Other Interventions

Sometimes, your doctor can recommend the following additional treatments:

  • Ketamine infusion therapy. Intravenous low-dose ketamine may provide relief from debilitating nerve pain in some patients with CRPS. The drug prevents pain receptors from firing in the brain.
  • Biofeedback & relaxation. They enable one to learn awareness and control over heart rate and muscle tension. Relaxing the body and reducing stress will help minimize flares.

Physical Therapy for Complex Regional Pain Syndrome

One of the most effective ways to manage CRPS is through physical therapy. CRPS can make it hard for the affected limb to move. Over time, this can lead to stiffness, weakness, and even muscle wasting. The fear of pain may make people avoid using the limb, which worsens the condition.

Physical therapy helps reduce pain, improve movement, and restore function. This treatment aims to retrain the nervous system and prevent further disability. It encourages safe, gradual movement. Common physical therapy techniques for CRPS include:

Desensitization Techniques

Desensitization reduces the higher sensitivity in the area. In CRPS, even light touches can be perceived as painful to the skin. Therapists use soft fabrics, textures, or vibrations to retrain the nerve’s response to touch. The objective is for the brain to learn that these feelings are not dangerous. Pain may lessen over time.

Range of Motion (ROM) Exercises

CRPS can lead to stiffness and limited movement. ROM exercises gently stretch the muscles and joints. These exercises prevent contractures and keep the joint moving normally. A therapist will guide you through safe, slow movements. With regular practice, the limb becomes more flexible and less painful.

Mirror Therapy

Mirror therapy involves the use of a mirror to reflect the intact limb. It gives the impression of a normalization of movement of the affected limb. The brain observes the movement and “re-trains” the pain signals. It is a clever and simple technique. After performing mirror therapy regularly, many patients report reduced pain and greater mobility.

Graded Motor Imagery (GMI)

GMI is a gradual brain exposure therapy designed to treat complex regional pain syndrome. It begins with the acknowledgment of limb placement in photographs. Next, you visualize the limb being moved, without actually moving the limb. Later, you make small actual movements. This approach serves to reintroduce the brain to the limb that was affected slowly. It assists people in reducing pain and the fear of movement.

Weight Bearing and Functional Use

Putting gentle pressure on the affected limb helps normalize function. Therapists may guide you to lean, press, or walk using the limb. Over time, these actions reduce swelling and improve strength. It also boosts blood flow, which aids healing.

Aquatic Therapy

Water provides support and resistance. In a pool, the limb can move more freely with less pain. The warmth of the water also relaxes muscles and improves circulation. Aquatic therapy is a safe, low-impact way to start active movement.

Strengthening Exercises

Once pain from CRPS begins to resolve, strength training becomes important. Weak muscles can result in imbalance and increased pain. Therapists have their patients use bands, light weights, or their body weight to help regain strength. Stronger muscles will support the joints and decrease pain with the activities of daily living.

Posture and Gait Training

CRPS can affect how people walk or carry themselves. Bad posture or limping can cause new problems. Therapists teach correct walking patterns and posture. This reduces strain on the body and helps restore normal movement.

Manual Therapy

Manual therapy involves hands-on techniques like massage and joint mobilization. These methods improve circulation, reduce stiffness, and ease pain. They also promote relaxation, which can help calm the nervous system.

Benefits of Physical Therapy for CRPS

Managing CRPS requires a multidisciplinary approach, and physical therapy is crucial in improving quality of life. The benefits of physiotherapy for CRPS include:

  • Pain management. Pain reduction is one of the primary objectives of physical therapy. Gentle, guided movement trains the nervous system and helps to shut down the overactive pain signals. Over time and with regular sessions, therapy can help lessen the hypersensitivity and help life feel less unmanageable.
  • Improved function. CRPS limits movement and weakens muscles. Physical therapy targets affected areas with stretching and strengthening routines. This helps restore range of motion, improve balance, and support independence in daily activities.
  • Improved circulation. Swelling and pain can be exacerbated by stiffness and inactivity. Increased blood irrigation to the affected limbs is obtained through movement-based therapy. Increased circulation decreases inflammation and aids in the repair of tissue.
  • Mental health support. Chronic pain can lead to depression and anxiety. Physical therapy encourages gentle activity, which releases mood-boosting endorphins. It also helps patients regain confidence in using their limbs.
  • Sustained recovery. Active treatment helps avoid issues such as atrophy of the muscles or stiffness of the joints. Being active and involved in the treatment process increases the probability of patients remaining in recovery.

Find Expert Physical Therapy Services Near Me

Complex Regional Pain Syndrome can deeply affect your physical and emotional well-being. Its symptoms can make everyday tasks feel overwhelming. Early diagnosis and a comprehensive treatment plan are critical for improving outcomes. There is no single cure for CRPS. However, a combination of physical therapy, medications, and psychological support can ease the symptoms.

If you seek a conservative treatment option for your CRPS, your doctor can recommend physical therapy. Your physical therapist will use techniques like graded motor imagery, range of motion exercises, and mirror therapy. The goal of physical therapy is to reduce pain, improve function, and restore a sense of control for those suffering from CRPS.

The outcome of your physical therapy treatment may depend on your provider's expertise. At Suarez Physical Therapy, we offer safe and effective physical therapy services for our Las Vegas, NV, clients. Call us at 702-368-6778 to book your appointment.