Most Injuries heal by itself. Sometimes post injury pain may remain for more than 3 months and is associated with swelling, redness and skin changes. this is called Complex regional pain syndrome or CRPS. This is also called as Reflex sympathetic syndrome or RSD.
CRPS may also develop after surgery, a heart attack, a stroke or other medical problem.
The pain may be burning sensation and is out of proportion to what is expected for the injury.
Symptoms include -
"Burning" pain in your arm, leg, hand or foot.
Skin sensitivity.
Some other features are changes in skin temperature, color and texture. Skin may be sweaty, cold or warm than normal. Skin color changes are also commonly seen and may be white or mottled to red or blue. Skin is hypersensitive (allodynia) sensitive to touch, gush of air, movements may be painful. Skin may be thin or shiny in the affected area.
There are changes in hair and nail growth.
We also see joint stiffness, swelling and damage. Along with these muscle spasms, weakness and muscle loss (atrophy) is also seen.
CRPS can be
- Type I (RSD) - No direct injury to nerves
- Type II (Causalgia) - following a distinct nerve injury.
When to see Pain Physician at PCI
When you experience constant, severe pain with all or few of the signs and symptoms mentioned above.
It's important to treat complex regional pain syndrome early. Early treatment can reverses the condition.
Rarely we see Complex regional pain syndrome spreading from its original affected area to other parts of the body and is called Continuity type CRPS.
Diagnosis - It's important to note that diagnosis is based on a physical exam and medical history.
Investigations that may help in diagnosis are
Bone scan.
Sympathetic blocks for diagnostic purpose - We have sympathetic nerves in the body running along the vertebral column. An image guided injection of local anaesthetic can relieve the pain and reverses the symptoms of CRPS. It helps in improving the blood flow and improving the temperature. Once diagnostic test is positive, radiofrequency ablation of these nerves may be planned for longer term relief.
X-rays - In late stages the bones look fragile and transperent due to loss of minerals.
