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Overview – Help for Complex Regional Pain Syndrome (Formerly known as
Reflex Sympathetic Dystrophy – RSD)
Although complex regional
pain syndrome (CRPS) was first described in Civil War veterans more than 140
years ago, it remains a poorly understood and sometimes undiagnosed disorder that
may affect millions of people in the United States alone. It is a disorder that
attacks both men and women, although the incidence is higher in women. The average age of CRPS patients is about 35,
but the disorder can affect people of all ages. While the causes and symptoms range widely from one person to the next, the one
over-riding symptom common to everyone with this disorder is severe pain that
seems out of proportion to the injury or illness with which it is
associated. In fact, pain is often the
first indication that the disorder is present and is a primary reason for
people with CRPS to seek medical advice and treatment. Over the years,
CRPS has been known by a number of different names including Sudecks atrophy,
post traumatic dystrophy and causalgia. Many people still use the popular term
reflex sympathetic dystrophy (RSD) syndrome when discussing this disorder.
However, in 1994, researchers and physicians from the International Association
for the Study of Pain (IASP) reclassified the terms. These are: The actual cause of this complex, often disabling syndrome
is not known. While many people develop
the syndrome in similar ways or experience common symptoms, there is no one
explanation for the disease. Symptoms may come and go in the early stages and
it is unknown whether some individuals are more susceptible to CRPS than
others. A number of factors are linked to CRPS, but the leading culprit
appears to be mild to severe trauma such as injuries or surgery. Something as simple as a sprain can lead to
CRPS. Many people who sustain some type
of injury may show signs of CRPS, while others become affected after surgery or
after experiencing a painful event, such as a heart attack or an infection in
an extremity such as an arm or leg.
People with neurologic disorders, such as multiple sclerosis, can also
develop CRPS, as can those with more chronically painful conditions such as
carpal tunnel syndrome. A severe type of this disorder, CRPS type II, may develop
when people injure a nerve or nerves in an extremity such as an arm, leg or
foot. Examples of this type of injury are gunshot wounds and crush injuries. Nerve injuries often are
characterized by numbness or tingling and/or sharp, shooting and aching pain in
the skin supplied by the injured nerve. This kind of pain is described as
"neuropathic" pain and can be confined to a small area of the body. CRPS is
likely to be occurring when that pain spreads to other parts of the extremity
and beyond and the autonomic nervous system becomes disordered. People with CRPS can experience a wide
variety of symptoms besides pain and autonomic dysregulation, especially in the early stages of the disorder. These may include skin discoloration, muscle
spasms, swelling and stiffness, feelings of heat or cold, dryness or excessive
sweating in the involved area, excessive hair growth and xcessive skin sensitivity to even the light touch of clothing (a symptom
doctors call allodynia). There also can
be extreme sensitivity to temperature and joint movement. In the later stages
severe complications, such as persistent pain, muscle atrophy and a decrease in regional bone
density, occasionally with fractures
(osteopinia), may occur. According to the
Reflex Sympathetic Dystrophy Syndrome Association of America (RSDSA), the
future is looking brighter for people with CRPS due to promising research
underway at institutions in the United States and throughout the world. This
research involves studying the basic processes that cause the disorder as well
as developing more effective treatments
for CRPS.
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