PT Classroom - Complex Regional Pain Syndrome: Successful Treatments for a Complex Condition  ׀ by Kostandinos Tsoulfas, MD

Complex Regional Pain Syndrome (CRPS) or Reflex Sympathetic Dystrophy (RSD), is one of the more complicated painful disorders to both explain and treat. An otherwise healthy patient can come to the office with complaints of aching or burning in the limbs or feelings of hot or cold. Visible symptoms may include skin on the arm or leg changing texture and color, swelling dramatically or becoming thin and shiny. In addition, patients may experience muscle atrophy, muscle tightening or tissue wasting.

CRPS cases often follow a forceful trauma to a limb. Ninety percent of CRPS patients have Type 1 CRPS, which occurs after an illness or injury to a limb, but not in the region or nerves of the affected limb. For example, a colleague of mine had a patient who underwent multiple foot surgeries only to develop CRPS in her hand. Type 2 follows a distinctive nerve injury.

Physical therapy can often be beneficial to help regain muscle strength, calm inflamed nerves and surrounding tissue and slow the progression of CRPS. Hot and cold applications to the site and topical analgesics can also be very beneficial. It is important that CRPS is diagnosed and treated early; otherwise it could progress to become more disabling.

Following physical therapy, suggested therapies for CRPS include nerve blocks, biofeedback and neurostimulation therapy. These therapies have proven very successful to help CRPS patients regain an active and healthy lifestyle. If you have a patient with symptoms of CRPS, talk with your local pain management physician to see how you can effectively co-manage the patient to help them restore function

Last revised: February 15, 2013
by Kostandinos Tsoulfas, MD