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


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