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Complex Regional Pain Syndrome

About Complex Regional Pain Syndrome (CRPS)

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Complex Regional Pain Syndrome (CRPS) is rare with a prevalence of 5–26 per 100,000 people annually; women 3–4x more affected; peak age 40–60, with up to 200,000 U.S. cases per year. CRPS is a chronic neurogenic pain disorder causing severe, disproportionate pain after minor injury or trauma, often in limbs, with sensory, autonomic, vasomotor, sudomotor/edema, and motor/trophic changes.

Types

  • Type I (~90% cases): No confirmed nerve injury (formerly reflex sympathetic dystrophy/RSD); follows soft tissue trauma, surgery, or immobilization.
  • Type II (~10%): Confirmed major nerve injury (formerly causalgia). Further subtypes: “warm” (acute, red/hot skin, ~70%) vs “cold” (chronic, poor prognosis); acute (<6 months) vs chronic.

Symptoms

  • Type I (no major nerve injury): Burning pain, hypersensitivity (touch/cold), swelling, warmth/redness (early) or cool/pale skin (late), rapid hair/nail growth, sweating changes, stiffness, weakness.
  • Type II(specific nerve damage): Identical sensory/autonomic symptoms (pain, skin changes, edema, motor issues) plus neuropathic signs tied to the injured nerve: shooting pain along its distribution, numbness, tingling, muscle weakness/atrophy in that nerve’s territory.

Known Causes

  • Primary: Aberrant neuroinflammatory response to trauma: central/peripheral sensitization, neurogenic inflammation, maladaptive neuroplasticity, sympathetic dysregulation.
  • Secondary: Fracture (most common), surgery, sprain/strain, immobilization; fibromyalgia, migraine predispose. No single etiology—multifactorial.
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