What is Complex Regional Pain Syndrome (CRPS)
Complex regional pain syndrome (CRPS) is a rare condition that describes chronic pain usually following an injury that is disproportionate to the initial injury. The chronic pain is categorised as neuroplastic pain, which means that changes to the nerve messages result in the perception of pain in the brain. It is important to acknowledge and understand that despite the perception of pain being in the brain, this does not mean that the pain is imaginary.
Most commonly, CRPS impacts the upper limb, but can be present anywhere in the body. CRPS is further categorised in two types that describe their causes.
- Type 1: occurs as a result of injury that does not damage the nerve, for example a ligament injury. Most cases of CRPS are type 1.
- Type 2: has similar symptoms to type 1, however occurs after a distinct injury to the nerve.
CRPS Symptoms
Common symptoms that point to CRPS are the following:
- Pain that occurs without stimulus or that is disproportionate to what is happening to effected area. An example is a cotton ball touching the area feeling like a razor.
- Increased swelling localised to the area that has CRPS
- Colour changes to the area that has CRPS, often red, purple, pale
- Increased hair or nail growth on the limb that has CRPS
- Increased sweating in the area impacted by CRPS
It should be noted that not all symptoms are experienced all of the time and that CRPS usually fluctuates. It may be that you have CRPS and not have some of the things listed above, it may also be that you have other symptoms not listed that are attributable to yoru CPRS.
Could it be something else?
At Newtown Physiotherapy and Pilates , your experienced hand therapist works within a team with your GP and other specialists to determine your diagnosis. There are not any specific tests that can diagnose CRPS on the spot, and a diagnosis is usually made based on the collection of clinical information from more than one health care professional.
You may have medical imaging that has a finding, such as a tear in a ligament or an issue with the tendon. Your Hand Therapist will discuss these findings and work with you to help you understand what symptoms may correlate to certain findings and what symptoms are due to CRPS.
How do we treat CRPS?
At Corio Bay Hand Therapy we tailor treatment towards your goals, focusing on getting you back to doing the things you want and need to do as part of your life. Usually, the successful management of CRPS takes a combined team effort between yourself and other health professionals such as GPs, Pain Specialists, Hand Therapists, Occupational Therapists, Physiotherapists, Exercise Physiologists and Psychologists just to name a few. We take the approach that you are the captain of your team. We want you to hand select the best clinicians for you to help you with your rehab.
In Hand Therapy some of the practices that we implement to help you reach your goals are:
- Education on your condition
- Gym rehab programs
- Home exercise programs
- Graded motor imagery
- Desensitisation
- Functional tasks analysis and intervention
CRPS management can take a few weeks to months, to several years depending on the severity. It is best to tackle your CRPS as early as possibly with intense therapy, often starting with 2-3 appointments per week for the first few weeks while we establish a home based program. After this, your hand therapist will work with you on a treatment plan that works in with you.