CRPS Diagnosis

CRPS Diagnosis

CRPS Diagnosis

Learn about CRPS diagnosis, its causes, and available treatment options. 

 

Table of Contents

What is Complex Regional Pain Syndrome (CRPS)?

Complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy (RSD) or Causalgia, is a “blanket term” that refers to a group of disease conditions marked by persistent painful sensations that appear to be excessive (in terms of severity) when compared with the trauma injury or lesion. CRPS disease is a progressive disease in that it usually starts in one limb/body part and then spreads out to other limbs if not treated early enough. Atrophy may even set in.1

Complex regional pain syndrome (CRPS) has two main classifications. Complex regional pain syndrome caused by damage to the soft tissue or bone is called Type 1. Type 2 CRPS is caused by damage or injury to the nerves of a limb.2 Usually, type 2 CRPS is more severe than its type 1 counterpart.

Who Gets Complex Regional Pain Syndrome (CRPS)?

Due to the complexity of the disease and challenges with detecting and diagnosing complex regional pain syndrome symptoms, it’s difficult to ascertain how common this disease condition is. This also makes it difficult to determine the distribution characteristics of the pain syndrome within a particular population.3

Complex regional pain has been observed in people of all ages, including children, although it occurs more frequently in women between 60 and 70.3

Does Complex Regional Pain Syndrome (CRPS) Affect Organ Function?

As earlier mentioned, CRPS disease is a progressive disease. Although complex regional pain syndrome symptoms are usually noticed in one limb/body part (at first), CRPS can affect every aspect of the body, including organ function, causing further complications like bladder problems, bowel dysfunction, and even abdominal pain.4

Injuries That May Lead to CRPS

CRPS disease is a complex medical condition with no “exact” known cause. However, one of the major risk factors that have been repeatedly linked to the occurrence of complex regional pain syndrome (CRPS) is the presence of injuries. Injuries that may lead to the occurrence of complex regional pain syndrome pain include the following below.5

Fracture – Broken Bone

Fractures are the most prevalent injuries leading to the occurrence of CRPS. In this type of injury, nerves are usually damaged or forced from their natural location either by broken/splintered bones or due to pressure from a cast bound too tightly.6 Prolonged casts may also result in tissue atrophy because of limb inactivity.

Penetrating Injury – Deep Wound or Laceration

CRPS can also be caused by damage to nerves resulting from penetration injuries or lacerations. These injuries damage the underlying superficial sensory nerves, leading to sensory alterations and CRPS symptom manifestations.6

Surgery

Nerve damage can occur due to surgical incisions, sutures, retractors, and placements during major surgical operations such as knee arthroscopy or a procedure to treat carpal tunnel. For the most part, CRPS resulting from damage made during surgical operations are easily discovered and corrected. However, there is also the possibility of developing CRPS after surgery even when the surgical procedure was perfectly carried out from start to finish.6

Cause of CRPS

Because there is very little information and understanding of complex regional pain syndrome (CRPS), there are quite several different postulations as to its causes. There is, however, still no “exact” cause recognized, although several of these proposed complex regional pain syndrome causes have been linked with CRPS disease. These causes include:

  • Sympathetic nervous system dysfunction
  • Somatic nervous system dysfunction
  • Neurogenic inflammation
  • Hypoxia
  • Psychological factors

How is Complex Regional Pain Syndrome Diagnosed?

Because CRPS is a progressive disease with symptoms like those of several other medical disease conditions, early and accurate diagnosis is vital to manage this pain syndrome successfully. No single test can confirm CRPS or identify the damaged nerve. CRPS is commonly diagnosed using the “Budapest Criteria.”6

 

The Budapest Criteria is a list of common signs of CRPS developed by an international consensus panel. This list is usually compared with several tests to determine if a person has complex regional pain syndrome pain. Tests carried out for CRPS diagnosis include the following:7

Bone Scan

A diagnostic bone scan method known as the “Triple-phase Bone Scan” is widely used to detect excess bone resorption in the body that occurs due to tissue atrophy. The detection of this excess breakdown of bone tissue in the body greatly aids diagnosis and localization.

Sweat Production Tests

There are several sweat production tests used as CRPS diagnostic tools. These tests include Resting Sweat Output (RSO), Thermoregulatory Sweat Test (TST), and Quantitative Sudomotor Axon Reflex Test, which is particularly useful in diagnosing small fiber neuropathy. The results from these tests are usually combined for final interpretation, and together, they have a very high CRPS specificity rate.8

X-rays

X-rays are a primary CRPS diagnostic tool in CRPS therapy. They are used to detect mineralization of bones that may occur because of atrophy resulting from inactivity. X-rays are also very effective fracture-detection tools. They’re precise as they can be used to detect minute changes in bone structure, thereby ensuring faster diagnosis of CRPS.8

Magnetic Resonance Imaging (MRI)

Magnetic Resonance Imaging (MRI) is another essential CRPS diagnostic tool. MRI detects and shows any underlying nerve damage via imaging technology. This will help identify those nerve damages characteristic of CRPS and aid in diagnosis.

CRPS Diagnosis

Treatment for CRPS at J. Flowers Health

CRPS diagnosis and treatment require some level of sophistication and experience. As a result, they should only be handled by experienced health care specialists who can correctly identify and successfully manage the illness. One such specialist in providing quality treatments for CRPS is the J. Flowers Health Institute. 

The J. Flowers Health Institute comprises groups of specialists and experts specializing in full and comprehensive health, substance use disorders, chronic pain, and general health and wellness, so patients are always assured of receiving the best possible care quality.9 CRPS treatment options offered at J. Flowers Health Institute include:

Medication

Several drugs have successfully treated and managed CRPS and related mental illnesses. However, the previous success of these CRPS medicines only offers a low guarantee of future successes, as individual reactions to these drugs vary. This means that some people will benefit more from these drugs than others. These medications include:

  • Topical anesthetics
  • Corticosteroids
  • NSAIDs and acetaminophen
  • Medications that provide muscle relaxation
  • Opioid analgesics
  • Neuropathic pain relievers
  • Vasodilators
  • Antidepressants6

Physical Therapy

Maintaining flexibility, strength, and function while moving the painful limb or body part promotes blood flow and helps in reducing circulatory symptoms. Physical therapy also helps prevent atrophy that might set in with inactivity of the affected body limb. This is important because the onset of atrophy often results in more severe treatment complications.

 

Other CRPS treatment options offered at the J. Flowers Health Institute include:

 

  • Counseling and psychological support
  • Intervention therapy
  • Implant therapy