How is CRPS treated? What research is currently being done on CRPS? Where can I get more information? Complex regional pain syndrome CRPS is a broad term describing excess and prolonged pain and inflammation that follows an injury to an arm or leg. CRPS has acute recent, short-term and chronic lasting greater than six months forms. People with CRPS have changing combinations of spontaneous pain or excess pain that is much greater than normal following something as mild as a touch.
Although CRPS improves over time, eventually going away in most people, the rare severe or prolonged cases are profoundly disabling. Most CRPS illnesses are caused by improper function of the peripheral C-fiber nerve fibers that carry pain messages to the brain. Their excess firing also triggers inflammation designed to promote healing and rest after injury. In some people the nerve injury is obvious but in others a specialist may be needed to locate and treat the injury.
CRPS is more common in women but can occur in anyone at any age, with a peak around age It is rare in the elderly, who have less inflammation after injury, and in young children who heal so quickly and completely. Because of the varied symptoms, the fact that symptoms may change over time, and the difficulty finding a positive cause in some cases, CRPS is hard to treat. There is no treatment that rapidly cures CRPS.
Most individuals do not have all of these symptoms, and the number of symptoms typically reduces during recovery. Most CRPS is caused by damage to, or dysfunction of, injured peripheral sensory neurons, which then has secondary effects on the spinal cord and brain.
The central nervous system is composed of the brain and spinal cord; the peripheral nervous system involves nerve signaling from the brain and spinal cord to all other parts of the body. It is unclear why some people develop CRPS while others with similar trauma do not. In more than 90 percent of cases, CRPS is triggered by nerve trauma or injury to the affected limb that damages the thinnest sensory and autonomic nerve fibers.
Poor circulation can impede nerve and tissue healing. Damage to the small fibers that control blood flow causes many symptoms of CRPS. Blood vessels in the affected limb can dilate open wider to leak fluid into the surrounding tissue, causing red, swollen skin.
This can deprive underlying muscles and deeper tissues of oxygen and nutrients, which can cause muscle weakness and joint pain. When skin blood vessels over-constrict clamp down , the skin becomes cold, white, gray, or bluish. CRPS develops only in the limbs because circulation is constrained there. Arterial blood pumped down to the hands and feet must fight gravity to return upwards in the veins to the heart. C-fiber damage can impede this, permitting blood fluids to remain in the limb where the swelling then further blocks return blood flow.
Slowed circulation impedes delivery of oxygen and nutrients needed for healing and sometimes causes spreading of cellular injury. Breaking the cycle by reducing limb swelling and restoring circulation is often the key that permits recovery to begin.
Poor nerve health. Conditions such as diabetes or exposure to nerve toxins can leave the nerves less resilient. A key to CRPS recovery is improving general nerve health by removing or improving conditions that slow nerve regrowth. Immune system involvement.
The C-fiber nerve cells also communicate with immune cells to help us heal from injury. Excess or prolonged nerve signaling can dysregulate immune cells in the affected limb, as does CRPS-associated poor circulation. Some people with CRPS have elevated local levels of inflammatory chemicals called cytokines that contribute to the redness, swelling, and warmth in the CRPS-affected limb.
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Physical and occupational therapy are considered first-line treatments for CRPS. Physical therapies improve blood flow, flexibility, strength, and function of the affected limbs to prevent or reverse the secondary brain changes that are associated with chronic pain.
These methods also train the brain to enhance motor coordination and functioning of the limbs. The experts at MidSouth Pain Treatment Center are equipped to help you manage your pain using interventional pain management procedures such as:.
This involves injecting an anesthetic into the spine to block the activity of the sympathetic nerve flow and offer temporary pain relief. This procedure involves placing stimulating electrodes into the spine through a needle to mask the pain signals before they reach the brain.
Once implanted, the patient can control the stimulator and adjust it using an external controller. If you suffer from pain, especially chronic pain, schedule an appointment with us.
Our team of doctors will work together with you to design a comprehensive treatment plan to help you live a pain-free life. Email [email protected]. Reflex Sympathetic Dystrophy. How Is This Condition Treated?
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