Complex Regional Pain Syndrome – What is it?
RSD is an abbreviation for Reflex Sympathetic Dystrophy, also known as CRPS (Complex Regional Pain Syndrome). CRPS is a chronic pain condition that involves complex changes in the nervous system. It also involves how the body responds to inflammation and how your immune system is triggered. Researchers are still working to fully understand why CRPS develops and why some people develop it after an injury while others do not.
Most people with RSD / CRPS seem to have had a minor injury that affected an arm or leg, a hand, or a foot. The pain experienced from RSD / CRPS is much more intense than the pain you would expect to feel. Giving you a feeling that the pain is way out of proportion to the injury. There are, however, some people who have gotten RSD/CRPS with no apparent injury to the affected limb. Although it is rare, some occurrences have been reported after surgeries. I know that the pain I experienced after I dropped the pallet on my left foot was way more intense than it should have been, and as time went on, it got worse.
Understanding Complex Regional Pain Syndrome
In this presentation from Musculoskeletal Health Australia, Dr. Anne Daly, a specialist pain physiotherapist, discusses what is known about CRPS, how it can affect the person living with it, and approaches to managing the condition.
About My Injury
It felt like my body was stuck in the same response pattern, similar to a record with a skip in it that keeps playing the same part of the song over and over. I dropped something on my foot; ouch, it hurt, and I felt a stabbing, sharp pain. Then my body told me to move my left foot so the muscles in my left leg contracted. Since my foot was bleeding, my body decreased the blood flow. With reduced blood flow, my leg and foot felt cold, and then they started to swell.
The contraction of the muscles in my leg was so tight that it was hard for me to initiate movement or complete movements. My foot would often stick when I walked. This cycle kept repeating itself over and over again, and I could feel it. I believe RSD is our body’s way of repeating these exaggerated responses. This repetitiveness is highly frustrating, painful, and stressful. A body under continual stress, in a heightened fight-or-flight response, experiences extra pressure on all its bodily systems, including the immune system.
Our Amazing Body
Let’s look at how amazing the body really is. For example, when we injure our arm, a pain signal is sent to our brain alerting it that something is wrong. This initial pain signal can vary depending on the type of injury that has occurred to your arm. The pain signal being sent can be mild, sharp, stabbing, shooting, burning, or a combination of these signals.
The body then quickly assesses the extent of the damage. If we cut ourselves, the body monitors the blood flow to the arm and then restricts and/or contracts the muscles in the arm, allowing us to move the arm out of harm’s way. Our heart beats faster, our breath is quicker, some of us may start sweating, while others may shiver. All of these responses by the body occur in a matter of seconds, and I feel that in the case of RSD/CRPS, they seem to persist long after the initial injury has healed.
Experts say Complex Regional Pain Syndrome (CRPS) was first recognized during the Civil War, when it was referred to as causalgia. Now, RSD / CRPS is classified as Type I or Type II. CRPS Type I occurs without a confirmed major nerve injury, while CRPS Type II is associated with a known nerve injury. Both Type I and Type II have the same symptoms. RSD affects everyone; however, it appears that women are more likely to get it.
Complex Regional Pain Syndrome Symptoms
Early diagnosis and treatment of RSD / CRPS are important. Symptoms can change over time and may vary considerably from one person to another. If you have persistent pain that seems out of proportion to an injury, along with symptoms such as swelling, changes in skin color or temperature, or difficulty moving the affected area, talk with your doctor.
- Pain is more intense than what should occur with an injury.
- Burning Pain.
- Changes in skin temperature, skin color, or skin texture.
- Changes in nail and hair growth on the limb occur with the initial injury.
- Swelling and stiffness in the injured area.
- Decreased ability to move the injured area.
For another viewpoint, there was an excellent article in Neurology Now about RSD / CRPS (Reflex Sympathetic Dystrophy). My own story and journey back to health is also available.
Interesting Video on What is Complex Regional Pain Syndrome – CRPS / RSD
I still find it sad that so many doctors still do not know about RSD / CRPS. Next time you are at your doctor’s, ask him if he knows what it is and help spread the word so people don’t have to wait so long to find out what they have. Early diagnosis and treatment are important because beginning appropriate treatment sooner may improve outcomes and help prevent further loss of function. Every September is Pain Awareness Month – let us all do our part, every day, and raise awareness about this syndrome.