Complex Regional Pain
Complex Regional Pain Syndrome
Complex Regional Pain Syndrome (CRPS), earlier called Reflex Sympathetic Dystrophy, is a condition characterised by burning pain, stiffness, swelling and discoloration of hand. It occurs due to a disturbance in sympathetic nervous system that controls the blood flow and sweat glands in the limbs.
Causes of Complex Regional Pain Syndrome
- Inadequately treated or untreated RSI, especially Thoracic Outlet Syndrome
- Traumatic injury
- Surgery
- Nerve compression
- Infection
- Cancer
- Stroke (or) hemiplegia
- In some cases of CRPS the cause is unknown.
Signs and Symptoms
Signs and Symptoms depend upon the duration.
I – 3 months
- Pain
- Burning ache
- Oedema
- Hyper (or) hypothermia
- Abnormal nail and hair growth
II – 3-12 months (Dystrophy)
- Constant swelling
- Skin wrinkles disappear
- Skin temperature decreased
- Nail become brittle
- Pain wide spread
- Increased stiffness
- Effected area become sensitive to touch
III – 1 year and above
- Skin Pale dry, tightly stretched and shiny
- Area Stiffness, pain decreased
Treatment
Phase I – Severe Pain or Discomfort
- Active ROM of the shoulder, wrist, and hand
- Forcible Passive ROM should be avoided
- Proprioceptive Neuromuscular Facilitation
- Myofascial release
- TENS
- Active exercise with TENS unit being worn
- Functional Electrical Stimulation
- Stress loading programme (compression exercises and active traction to the joint)
- Oedema control elevation, compression bandage
- Wax bath
- Taping
- Breathing exercises and relaxation techniques
Phase II – Moderate Pain or Discomfort
- Many pain relieving modalities
- electrotherapy
- exercise therapy
Phase III – Mild Pain or Discomfort
- Passive motion as tolerated
- Stretches
- Muscle reeducation
- Postural and ergonomics training
- Preparation for return to work
- Electro Therapy
Phase IV – Maintenance
- Strength Excercises
- Stretches Excercises