Complex Regional Pain Syndrome

By Author: Dr. Victor Marchione
Total Articles: 90
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Here is a condition that you might not have heard of, but which is actually quite prevalent in the U.S.: Complex Regional Pain Syndrome (CRPS) is a chronic progressive disease that is characterized by severe pain, swelling and changes in the skin.

The International Association for the Study of Pain has divided CRPS into two types, based on the presence of nerve lesion following the injury: Type I, also known as “Reflex Sympathetic Dystrophy” (RSD) and Type II, also known as “Causalgia,” has evidence of obvious nerve damage.

Many people suffer from this very painful condition, and it can strike at any age.

CRPS is usually caused by illness, injury and surgery that has already affected the area.

There are, however, documented cases that have no injury to the original site.
CRPS was originally described by a soldier during the American Civil War, who is sometimes also credited for inventing the name “causalgia,” which, in fact, comes from the Greek words for “heat” and “pain.”

In the 1940s, the term “reflex ...
... sympathetic dystrophy” came into use to describe this condition, based on the theory that a “sympathetic” response was involved in the cause of the disease.

The Symptoms of CRPS
The symptoms of CRPS usually occur near the site of an injury, then spread beyond the original area.

Symptoms may eventually involve the entire limb, and sometimes even the opposite limb and/or other appendages.

The most common symptoms are burning and shooting pains.

Those with the condition may also experience muscle spasms, local swelling, increased sweating, softening of bones, joint tenderness or stiffness, restricted or painful movement and changes in the nails and skin, dry skin over the complete body and, finally, rapid shedding of skin.

The pain of CRPS is continuous, and is often aggravated by emotional stress.

Moving or touching the limb is often intolerable for those who are suffering from the condition.

Eventually, the joints become stiff from disuse, and the skin, muscles and bone may atrophy.

It can be difficult to diagnose CRPS, because no specific test is available.

Treating CRPS
If you suffer from CRPS, your doctor may prescribe a variety of drugs. Antidepressants, anti-inflammatories and “COX-inhibitors,” as well as “opioids,” are commonly used. Occupational physical therapy may also used to treat CRPS. Some medical practitioners prescribe an injection of a local anesthetic to temporarily ease painful symptoms with injections being repeated as needed.
“Neurostimulation” (a spinal-cord stimulator) has also been tried. This treatment involved surgically implanting a device to reduce the pain by directly stimulating the spinal cord. These devices place electrodes either in the epidural space above the spinal cord or directly over nerves that are located outside the central nervous system.
Physical therapy may be the most promising of these treatments, but many patients are incapable of participating due to muscular and bone problems. People who are struggling with CRPS often avoid using or touching the affected limb(s). Unfortunately, inactivity seems to worsen the disease.
Some treating physicians have even tried using physical therapy under light general anesthesia in an attempt to control CRPS. Unfortunately, the unpredictability of this illness often causes a frustrating pattern of “one step forward, two steps back” when it comes to recovery.

DMSO Helps Manage CRPS
“Dimethyl sulfoxide” (DMSO) may very well offer an effective alternative in the treatment of this challenging condition. Researchers in the Netherlands wanted to compare the use of “acetylcysteine” to DMSO for patients with RSD. They performed a double-blind, randomized, controlled trial on patients with RSD for one year. They concluded that DMSO caused an improvement in symptoms and is the preferred treatment for patients with RSD.5
In another study, researchers performed a clinical trial on patients who were suffering from RSD. The randomized, double blind study was performed in 32 patients, all of whom suffered from acute RSD. In each of these patients, the primary injury was the result of a previous accident.
The study involved treatment with either a fatty cream containing 50% DMSO or a placebo. Both groups administered the cream for two months. All patients received physiotherapy as well. The improvement of the RSD symptoms in patients who used the DMSO cream was significantly better compared to the placebo group. The research team concluded that DMSO cream should be a recommended treatment in patients suffering from RSD.6

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