Complex regional pain syndrome is characterized by swelling, extreme pain, and changes in the skin. Muscle spasms, stiffness in affected joints and changes in blood vessels are often noticed first.

Changes in fingernails and softened bones, along with weak muscle tone, are typically observed next. Finally, the syndrome causes irreversible changes in skin and bone, along with involuntary contractions of the tendons and muscles that flex the joints. However, some cases never progress beyond the mild or moderate stage.

Complex Regional Pain Syndrome Types
There are two types, based on the absence or presence of nerve lesion.

Type I, also known as reflex sympathetic dystrophy (RSD) or Sudeck’s atrophy, lacks nerve lesions and is triggered by injury to tissue.

Type II is associated with obvious nerve damage as well as injury to tissue. The older term “causalgia” was first used during the Civil War, when injured soldiers reported major pain resulting from apparently minor damage to nerves.

Complex Regional Pain Syndrome Symptoms
Complex regional pain syndrome commonly starts with an injury or surgery, most often on a limb. Symptoms often spread beyond the boundary of the original trauma, sometimes involving the whole arm or leg, and often the opposite limb as well.

Burning, severe pain at the site of the injury combined with localized edema or swelling and changes in skin temperature and/or color are typical, along with softer bones and painful movement. In some cases, touching or trying to move the affected area produces intense pain.
Diagnosis can take several visits to various doctors, and is made when other possible causes have been ruled out.

Complex Regional Pain Syndrome Treatment
There is an immense amount of research currently being conducted on ways to relieve chronic pain. Many different methods have been tried with complex regional pain syndrome, and current standards usually combine assorted drug treatment with physical and occupational therapy.

Anti-inflammatories, alpha- or beta-blockers, GABA analogs and opioids are all used, but without compelling evidence of their overall effectiveness over time. Nerve blocks give some patients relief from pain.

Neural stimulators have been shown to be effective at relieving pain in studies, including spinal cord stimulation for both types I and II. Compared to physical therapy alone, physical therapy and spinal cord stimulation reduced the intensity of pain and more patients reported a “much improved” outcome, but the range of movement in the limb remained the same.

Surgical sympathectomy is sometimes used in patients who get significant relief of pain with nerve blocks, but who want a more permanent solution. However, its use is controversial as some doctors believe sympathectomy, which destroys the nerves involved in CRPS, is unwarranted and makes the condition worse.

Psychotherapy can be helpful in many cases, particularly when family, friends and colleagues are skeptical about the existence of severe pain. Those with CRPS can develop depression, anxiety or post-traumatic stress disorder, and antidepressants can play a valuable role in recovery.

Complex Regional Pain Syndrome Cure
Although there is currently no cure, spontaneous remission from symptoms does occur in some people. Others experience chronic pain and crippling in the affected areas in spite of treatment. Many medical professionals are convinced that treatment should begin as early as possible in the course of the disease to be most effective.