How is Complex Regional Pain Syndrome Diagnosed?
CRPS is diagnosed based on a physical assessment and your medical history. There is no single test that can definitively diagnose CRPS, although the techniques listed below may provide good information:
Bone Scan:
This method may aid in the detection of bone abnormalities. A radioactive chemical injected into one of your veins allows a special camera to see your bones.
Sweat Production Test:
Some tests can determine how much sweat is produced on both limbs. Inconsistent results may indicate CRPS.
X-Rays:
Mineral loss from your bones may be visible on an X-ray in the latter stages of the disease.
Magnetic Resonance Imaging (MRI):
Images from an MRI test may reveal tissue alterations that rule out other illnesses.
What Causes Complex Regional Pain Syndrome
The precise cause of CRPS is unknown. It is assumed to be caused by an injury to the peripheral and central nervous systems. CRPS is usually due to a trauma or an injury. CRPS has two categories, each with identical indications and symptoms but distinct causes:
Type 1:
This form, also known as reflex sympathetic dystrophy (RSD), develops following an illness or injury that did not directly destroy the nerves in the affected limb. Type 1 CRPS affects approximately 90% of patients.
Type 2:
This type, formerly known as causalgia, exhibits symptoms similar to type 1. However, type 2 CRPS develops after specific nerve damage.
Many cases of CRPS develop due to a traumatic injury to an arm or leg. It can include a fracture or a crushing injury. Other traumas, such as surgery, heart attacks, infections, and sprained ankles, can also result in CRPS.
It is unclear why these traumas can result in CRPS. Not everyone who sustains such an accident will develop CRPS. It could be due to an unusual connection between your central and peripheral nervous systems and various inflammatory reactions.
Symptoms of Complex Regional Pain Syndrome
Complex regional pain syndrome symptoms may not have to be present in everyone. However, many patients have the majority of the following:
- Skin discoloration
- Throbbing or burning pain that lasts three months or more
- Increased sensitivity to cold or pressure
- Swelling in the affected extremities
- Rapid temperature changes (feeling cold and hot)
- Changes in hair or nail growth
- Increased joint immobility or inflexibility
- Muscular spasms
- Muscular atrophy (loss of muscular tonicity)
Complex Regional Pain Syndrome has two main symptoms:
- Pain is due to a non-painful stimulus (for example, when a breeze blows over your skin
- An unpleasant stimulus creates far more irritation and pain than expected.
Treatment Options for Complex Regional Pain Syndrome
CRPS is diagnosed based on a physical assessment and your medical history. There is no single test that can definitively diagnose CRPS, although the techniques listed below may provide good information:
Bone Scan:
This method may aid in the detection of bone abnormalities. A radioactive chemical injected into one of your veins allows a special camera to see your bones.
Sweat Production Test:
Some tests can determine how much sweat is produced on both limbs. Inconsistent results may indicate CRPS.
X-Rays:
Mineral loss from your bones may be visible on an X-ray in the latter stages of the disease.
Magnetic Resonance Imaging (MRI):
Images from an MRI test may reveal tissue alterations that rule out other illnesses.
1. Biofeedback/Physical Therapy:
Your doctor may recommend physical and occupational therapy along with other therapies to reduce or avoid functional impairments. Biofeedback encourages CRPS patients to be more aware of and familiar with their bodies.
2. Mirror Therapy:
A mirror is used in this therapy. Sitting in front of a mirror or mirror box, you move the healthy limb such that the brain perceives it as the CRPS-affected limb. According to research, this form of therapy may assist people with CRPS enhance their mobility and minimize their pain.
3. Medications:
Membrane stabilizing medications and NSAIDs are useful pharmacological therapy for the medical management of CRPS.
4. Sympathetic Nerve Blocks:
In this procedure, your doctor inserts a small, delicate needle through the skin to the sympathetic nervous system’s roots. When nerve block occurs, some people experience tremendous pain alleviation.
The stellate ganglion block and brachial plexus nerve block are two procedures that target the face and upper extremities. Lumbar sympathetic nerve blocks are frequently helpful in the treatment of CRPS in the lower limbs.
5. Infusion Methods:
A tiny catheter is inserted through a needle into the epidural space or close to injured nerves.
Local anesthetics and other medications are administered through the catheter for extended periods of time. Pain relief can be significant and long-lasting by continually blocking the nerves with an infusion.
6. Spinal Cord Stimulation (SCS):
Spinal cord stimulation involves using tiny electrodes implanted near the spinal cord in the epidural region. The electrodes send a modest electrical current to the spinal cord, which blocks pain transmission and thus provides pain relief.
7. Dorsal Root Ganglion Stimulation (DRG):
This approach is a new type of neurostimulation therapy meant to treat chronic pain in difficult-to-treat parts, such as the foot, knee, hip, or groin. Your doctor will place tiny electrodes near the damaged dorsal root ganglion nerves. The electrodes provide a mild electrical current that blocks pain transmission and relieves pain.
It is a good option if you have:
- Chronic pain
- Isolated persistent pain in the lower extremities, such as the foot, knee, hip, or groin, as a result of an injury or surgery
- Traditional neurostimulation, surgery, pain medicines, nerve blocks, and other pain management techniques provide little or no relief.
- If you suffer from this pain, DRG therapy may work when others have failed or provide partial relief.
