Today, Complex Regional Pain Syndrome (CRPS) also known as reflex sympathetic dystrophy (RSD), polyneuropathy, central pain syndrome, and more than 20 other names affects millions of people worldwide. It is estimated that there are 50,000 new cases each year in the United States. CRPS develops after a trauma, injury or perceived trauma to the sympathetic nervous system, causing it to send constant pain signals to the brain, triggering a great deal of pain. It is difficult to turn the pain signals off once it becomes chronic, lasting longer than 3 months. Since the sympathetic nervous system also regulates heart rate and blood pressure, these can also be affected. There is a complete list of possible symptoms at internationalpain.org/rsd-crps.
For many years, the legal profession treated CRPS cases as an invention created by trial attorneys to gain a jury’s sympathy, so they would collect large settlements for their clients. During my legal career, I handled four CRPS cases. My first client was injured at a concert she attended when someone stepped on her foot with a high heel, fracturing her toe. The second client slipped and fell on a grape in the supermarket, fracturing bones in her foot. The third client was working as a maintenance man at a high school, when a manhole cover fell on his foot, breaking several bones. My fourth client, an ordained minister, was driving when another vehicle that caused a crash cut her off, breaking her wrist.
There are two categories: type one and type two. The difference between them is that Type two has ‘known’ nerve damage. The first documented case occurred during the American Civil War by Dr. Silas Weir-Mitchell. Soldiers suffered chronic pain, burning sensations from shotgun wounds even after the bullets were removed from the patient, and injuries had healed. This disease can affect one extremity like a finger or arm, or all of parts of the body including internal organs. We now know that this disease has a neuro-autoimmune component and affects all systems of the body. No matter which type you have, the treatments are similar whether the providers figure out the trauma that triggered it or not.
Many treatments are available today, a few of which are: specialized physical therapy, which will help increase mobility to the affected area; acupressure to assist with circulation; and to assist with the burning pain; infusion therapies such as lidocaine, ketamine, IVIg, PRP, plasma; neuro-stimulators and opioid pump implants. A mental health professional should also be consulted to help manage depression, anger, and anxiety that may develop due to the life changes that arise. There are also medications that may be helpful.
If you are experiencing any of these symptoms especially the hallmark symptom of burning fire pain, make an appointment with a specialist. Early diagnosis is very important. A number of tests are available, including thermogram, MRI, bone scan, and nerve blocks can assist with diagnosis of this disease. Early treatment may possibly avoid the risk of spreading to other parts of the body.
If you recognize yourself having similar symptoms, call your doctor and get tested. CRPS affects more women than men. You can get more information on CRPS/RSD by contacting the following organizations the International Pain Foundation www.internationalpain.org or The National Institute of Neurological Disorders & Stroke, http://www.ninds.nih.gov
A Look at CRPS by Richard Sinrod, Ret. Attorney
Edited by iPain Living Staff
