Frank Metts
03-15-2014, 11:13 PM
Complex regional pain syndrome (CRPS) formerly reflex sympathetic dystrophy (RSD), "causalgia", or reflex neurovascular dystrophy (RND) is an amplified musculoskeletal pain syndrome (AMPS). It is a chronic systemic disease characterized by severe pain, swelling, and changes in the skin. CRPS is expected to worsen over time. It often initially affects an arm or a leg and often spreads throughout the body; 92% of patients state that they have experienced a spread, and 35% of patients report symptoms in their whole body.
Complex Regional Pain Syndrome is a multifactorial disorder with clinical features of neurogenic inflammation (swelling in the central nervous system), nociceptive sensitisation (which causes extreme sensitivity or allodynia), vasomotor dysfunction (blood flow problems which cause swelling and discolouration) and maladaptive neuroplasticity (where the brain changes and adapts with constant pain signals); CRPS is the result of an "aberrant [inappropriate] response to tissue injury". Treatment is complicated, involving drugs, physical therapy, psychologic treatments, and neuromodulation and is usually unsatisfactory, especially if begun late.
CRPS is associated with dysregulation of the central nervous system and autonomic nervous system resulting in multiple functional loss, impairment, and disability. The International Association for the Study of Pain has proposed dividing CRPS into two types based on the presence of nerve lesion following the injury.
Type I, formerly known as reflex sympathetic dystrophy (RSD), Sudeck's atrophy, reflex neurovascular dystrophy (RND), or algoneurodystrophy, does not have demonstrable nerve lesions. With the vast majority of patients diagnosed with CRPS being of this type, most of the literature thus refers to type I.
Type II, formerly known as causalgia, has evidence of obvious nerve damage. Type II CRPS tends towards the more painful and difficult to control aspects of CRPS type II scores 42 out of 50 on the McGill pain scale (however there is seemingly little or no data pertaining to type I specifically here). In Type II the "cause" of the syndrome is the known or obvious nerve injury, although the cause of the mechanisms of CRPS Type II are as unknown as the mechanisms of Type I.
CRPS has the unfortunate honour of being described as the most painful long term condition (of those that have been tested), scoring 42 out of a possible 50 on the McGill pain scale, above such events as amputation and childbirth. Lack of social awareness has inspired patients to campaign for more widespread knowledge of CRPS, and lack of clinical awareness has led to the creation of support groups seeking to self-educate with the latest
Complex Regional Pain Syndrome is a multifactorial disorder with clinical features of neurogenic inflammation (swelling in the central nervous system), nociceptive sensitisation (which causes extreme sensitivity or allodynia), vasomotor dysfunction (blood flow problems which cause swelling and discolouration) and maladaptive neuroplasticity (where the brain changes and adapts with constant pain signals); CRPS is the result of an "aberrant [inappropriate] response to tissue injury". Treatment is complicated, involving drugs, physical therapy, psychologic treatments, and neuromodulation and is usually unsatisfactory, especially if begun late.
CRPS is associated with dysregulation of the central nervous system and autonomic nervous system resulting in multiple functional loss, impairment, and disability. The International Association for the Study of Pain has proposed dividing CRPS into two types based on the presence of nerve lesion following the injury.
Type I, formerly known as reflex sympathetic dystrophy (RSD), Sudeck's atrophy, reflex neurovascular dystrophy (RND), or algoneurodystrophy, does not have demonstrable nerve lesions. With the vast majority of patients diagnosed with CRPS being of this type, most of the literature thus refers to type I.
Type II, formerly known as causalgia, has evidence of obvious nerve damage. Type II CRPS tends towards the more painful and difficult to control aspects of CRPS type II scores 42 out of 50 on the McGill pain scale (however there is seemingly little or no data pertaining to type I specifically here). In Type II the "cause" of the syndrome is the known or obvious nerve injury, although the cause of the mechanisms of CRPS Type II are as unknown as the mechanisms of Type I.
CRPS has the unfortunate honour of being described as the most painful long term condition (of those that have been tested), scoring 42 out of a possible 50 on the McGill pain scale, above such events as amputation and childbirth. Lack of social awareness has inspired patients to campaign for more widespread knowledge of CRPS, and lack of clinical awareness has led to the creation of support groups seeking to self-educate with the latest