Complex regional pain syndrome (CRPS)

Overview

Complex regional pain syndrome (CRPS, Sudeck's atrophy) is a functional disorder of the autonomic nervous system in the arms or legs. It mostly occurs after an injury. Painful swelling, bluish discolouration of the skin and muscle wastage are typical. There are many treatment approaches, all of which should be started as early as possible.

Symptoms

Main symptoms

• Initially, normal recovery of the injured extremity (arm or leg)
• In the course of recovery, pain at rest and during movement
• Swelling of the skin (doughy, tight and shiny)
• Reddish, blue-tinged skin discolouration
• Increased sweating
• Reduced sense of touch and / or temperature sensation
• Overheating
• Joint mobility can be restricted

Other symptoms

• Muscle wastage
• The skin shrinks, becomes smooth, shiny and difficult to move (skin atrophy)
• Joint stiffness
• Osteoporosis

Causes and treatment

Causes

• The cause has not been determined
• Often occurs after an injury to the arms or legs, e.g.
  • Fracture
  • Nerve injury
  • Constricting bandages
  • Operation

Further treatment by your doctor / in hospital

Possible tests

• Blood test (inflammatory markers)
• X-ray
• CT scan (computed tomography)
• MRI (magnetic resonance imaging)
• Scintigraphy (specialised procedure to produce pictures (scans), for example of inflammation)

Possible therapies

• Immobilisation of the injured limb in a relaxed position
• Medication (e.g. painkillers, cortisone, vitamin D, antidepressants, hormones)
• Medication to block pain in certain nerves (injection)
• Lymph drainage
• Acupuncture
• Ultrasound
• Relaxation methods (e.g. progressive muscle relaxation)
• Surgery (very rarely)

What can I do myself?

• Lukewarm arm or foot baths can soothe the pain
• Regular movement and dexterity exercises as instructed by a physiotherapist
• Moderate muscle-strengthening training

When to see a doctor?

• Pain after an injury which initially improves, but then worsens again

Synonyms

Sudeck's syndrome, CRPS, complex regional pain syndrome, Sudeck's atrophy, reflex sympathetic dystrophy, Complex regional pain syndrome (CRPS), Complex regional pain syndrome