CRPS is typically triggered by an injury to an arm or leg—even a minor injury can lead to CRPS. Pain persists and can worsen even after the original injury has healed. It isn’t clear why some children develop CRPS while others with similar injuries do not. In addition to CRPS, doctors may also refer to this condition as reflex sympathetic dystrophy (RSD).
CRPS is triggered by an injury like a sprain, fracture, cut, or immobilization that damages the thinnest peripheral sensory nerves. In about 10% of people with CRPS, it occurs spontaneously. CRPS is a body’s abnormal response or overreaction to an injury. It affects both the peripheral nervous system and the central nervous system. The damage to nerve fibers results in pain, inflammation and blood vessel changes. In CRPS, the damaged nerves continue to send pain messages to the brain even after the original injury has healed.
What are the Symptoms of CRPS
What are the Symptoms of CRPS
Typical symptoms of CRPS include:
- Prolonged pain after an injury has healed
- Extreme skin sensitivity or a burning pain reaction to things like a gentle or light touch
- Changes to the skin, such as a pale, blue, red or shiny appearance
- Swelling in the affected limb
- Temperature changes in the affected limb, which may feel cooler or warmer than the other limb
- Changes in nail growth, hair growth or sweating in the affected limb
- Decreased range of motion in the affected limb
- Weakness or abnormal movements in the affected limb
How is CRPS Diagnosed
How is CRPS Diagnosed
CRPS is diagnosed based on medical history and a physical exam by your doctor. There are specific criteria (called Budapest Criteria) used to diagnose CRPS. There is no blood test or special testing that can help diagnose CRPS.
Early diagnosis is important so that treatments can be started to regain full function. Early detection of this condition helps increase the effectiveness of treatment. Delays in starting appropriate treatment can worsen or prolong the condition.
How is CRPS Treated
How is CRPS Treated
Treatment of CRPS is focused on the various affected areas of the body. The goal is to restore function and improve pain. It is often helpful for families to learn about CRPS and how pain works in the body so that they can understand the goals of treatment. A child with CRPS may become inactive because any movement is too painful. But physical activity is one of the best treatments for pain disorders because it helps retrain the affected nerves. Through physical activity, your child’s body changes how the nerves send pain signals to the brain.
The Pain Management Program at Riley Children’s Health offers a multi-disciplinary approach to treating the various symptoms of your child’s CRPS, including:
- Cognitive behavior therapy (CBT) to develop active coping skills to manage pain
- Physical therapy and desensitization activities to retrain the nerves
- Medications to treat chronic nerve (neuropathic) pain
- Anesthetics or nerve blocks to “reboot” the nerves
- Graded motor imagery, including mirror-box therapy to improve movement
- Intensive inpatient rehabilitation
- Surgical placement of a dorsal column stimulator, which creates stimulation at the spinal cord to interrupt pain signals coming from the affected area
Does CRPS Get Better
Yes, symptoms can resolve and remain in remission indefinitely. However, there is no treatment that rapidly resolves CRPS, and limb function typically improves before pain. Some children may have CRPS for several months, undergo treatment, become fully functional and never experience issues again. Others may see their CRPS disappear suddenly, without treatment. And there are some children who manage fluctuating pain and symptoms for years. Children who experience CRPS may be susceptible to recurrence of the condition, which means CRPS could return following an injury years later. This is why it’s important for your child to learn pain management coping skills, which may be useful again later in life.
Key Points to Remember
Key Points to Remember
- It is more effective to treat CRPS when it is diagnosed early.
- Physical therapy, physical activity and active coping skills are key to healing from CRPS.
- Treatment of CRPS typically involves a combination of therapies to maximize your child’s ability to have a good quality of life and function.
Departments Treating This Condition
Departments Treating This Condition
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