Complex Regional Pain Syndrome (CRPS)

In some rare circumstances, CRPS can lead to physical complications. These are:

• Bed sores, also known as pressure ulcers.
• Muscle atrophy, where the muscles begin to deteriorate.
• Muscle contractures, this is when muscles shorten and lose the normal range of movement.

All of the above can make it difficult to move and get around for someone with CRPS.

The exact cause of CRPS is not fully understood, but it is believed to result from dysfunction in the central or peripheral nervous system. Potential triggers include:

• Trauma or injury: Such as fractures, sprains, or surgery. Even minor injuries can sometimes lead to CRPS.
• Nerve damage: Particularly in CRPS-II, where there is a direct nerve injury.
• Immune system response: Inflammatory responses following an injury might contribute to CRPS development.
• Genetic factors: There may be a genetic predisposition that increases the risk of developing CRPS.

CRPS not only affects physical health but can also have profound impacts on mental well-being. The chronic nature of the condition, along with persistent pain and physical limitations, can lead to various psychological challenges.

Here’s how the condition can lead to mental health problems:

Chronic Anxiety and Stress

Persistent pain and uncertainty about the condition can lead to heightened anxiety and stress levels. Patients often worry about the progression of CRPS and its impact on their daily lives and future.

Depression

The ongoing pain and physical restrictions can lead to feelings of hopelessness and sadness. Depression is common due to the chronic nature of CRPS and its impact on quality of life.

Sleep Disturbances

Pain and discomfort can lead to difficulty falling asleep or staying asleep, resulting in insomnia. Poor sleep quality further aggravates mental health issues, creating a vicious cycle of pain and psychological distress.

Social Withdrawal and Loneliness

The limitations imposed by CRPS can reduce participation in social activities and work, leading to feelings of isolation and loneliness.

Cognitive Impairments

Chronic pain and associated stress can affect cognitive functions, including concentration, memory, and decision-making abilities. These impairments can hinder daily functioning and exacerbate feelings of frustration and helplessness.

Low Self-Esteem

Changes in physical appearance, such as swelling, skin colour changes, and muscle atrophy, can affect body image and self-esteem. People with CRPS may struggle with accepting these changes, leading to reduced confidence.

Emotional Instability and Mood Swings

The constant pain and frustration associated with CRPS can result in mood swings and emotional instability. Individuals may experience increased irritability, anger, and emotional outbursts.

If you, or a loved one experience pain that is preventing you from carrying out daily activities, it is worth a visit to your GP. Although it can be difficult to diagnose, it’s best to seek help at the earliest to help reduce painful symptoms.

There is no single test that can diagnose CRPS however, it is often diagnosed by ruling out other conditions with similar symptoms. These can be done by a series of tests which are:

• Blood tests - these will rule out any underlying infection or arthritis.
• MRI (Magnetic Resonance Imagine) Scan - this is to rule out problems with your bones or tissue.
• X-Ray - this is to rule out any issues with joints or bones.
• Nerve Conduction Studies - to rule out damage to the nerves.

Your GP or a specialist may also carry out a physical examination to check for physical indications of CRPS, like swelling to changes in skin temperature and appearance. The examination will be carried out carefully to not inflict further pain on the patient.

If no other possible cause can be found and a person has clear symptoms, they are usually diagnosed with CRPS. Following diagnosis or if the conclusion is uncertain, often you are referred to a local specialist pain clinic. Treatment should be started quickly so it is essential for a referral as soon
as possible.

Although there is no known cure for people with CRPS, a combination of physical treatments, medication and psychological support can help manage symptoms.

Studies show an estimated 85% of people with CRPS experience a slow reduction in page and some of their symptoms in the first 2 years.

However, others with CRPS experience continuous pain despite receiving treatment.

Treatment Plans

There are 4 main areas involved within CRPS treatment. These are:

1. Education and self-management - these are steps and advice on how to help manage the condition.
2. Physical rehabilitation - this is designed to help improve your function and reduce the risk of long-term physical problems. Learn more about physiotherapy exercises here.
3. Pain relief - to help reduce pain
4. Psychological support - advice and methods on how to cope with the emotional impact of living with the condition. Examples include cognitive behavioral therapy (CBT) and group therapy sessions.

Here are some frequently asked questions associated with CRPS:

How does CRPS affect a person's daily life?

The chronic pain, physical limitations, and potential mental health challenges can make it difficult to perform everyday tasks, work or engage in physical activities. Simple actions such as walking, using the affected limb, or even getting restful sleep can become challenging. Additionally, the uncertainty about the condition and its long-term effects can lead to heightened anxiety and stress, affecting the over quality of life.

Can CRPS be cured?

There is currently not cure for CRPS, but early and comprehensive treatment can significantly improve symptoms and quality of life. Many patients achieve good pain control and improved functionality with a combination of medical treatments, pain therapy, and psychological support. Ongoing management is often necessary to prevent flare-ups and maintain progress.

How can family members and caregivers support someone with CRPS?

Providing understanding, empathy, and practical assistance are ways to support someone with CRPS. It's important for them to educate themselves about CRPS to better comprehend the challenges their loved one is facing. They can assist with daily tasks, offer emotional support, and encourage the individual to adhere to their treatment plan. Additionally, promoting a positive and accommodating environment can help the person with CRPS manage their condition more effectively.

CRPS UK - A patient-led organisation, supporting people with the condition, their families, friends and healthcare professionals.

Visit the CRPS UK website for advice, support and helpful resources.

Burning Nights - An independent organisation raising awareness, education and support for people affected by CRPS through every step of their journey.