CRPS is a poorly understood condition. It occurs most commonly following injury or surgery, although it can also occur following heart attacks, strokes or infections. It usually affects the hands or feet although it can also affect the ankles, knees or shoulders. CRPS varies considerably in severity and is also known by a number of other names including Reflex Sympathetic Dystrophy (RSD) and Algodystrophy. Why does CRPS occur?
We do not know exactly why it occurs. It is thought that in patients with CRPS the body’s response to injury or surgery is exaggerated causing more pain, stiffness, and/or swelling, than normally expected. Who gets CRPS?
Unfortunately anyone can be affected. It may occur in up to 30% of cases following wrist fracture although in most cases the symptoms are mild and resolve. There is no way of predicting who will be affected and there is no known way of preventing it. What effects does CRPS have?
This is the most common complaint and is usually out of proportion to the severity of the injury. The affected part is often sensitive to touch and just stroking the area can cause pain. Sudden shocks or jolts can also result in increased pain. When this is experienced it does not mean that further damage is being done.
These are often linked. Fingers/toes may be swollen and because of this, mobility is restricted and stiffness experienced. In the hand this may result in difficulty making a fist.
3. Changes in skin colour, temperature and sweating
The affected part can become hot and red, or cold and blue. The hand or foot may sweat more profusely than on the unaffected side. Occasionally changes in the skin, nails and even hair growth are experienced. How is CRPS diagnosed?
The diagnosis is made by the symptoms described and also by the examination performed by the doctor. In later cases there may be changes seen on x-ray or bone scan. How is CRPS treated?
Physiotherapy - is the main treatment. The aim of physiotherapy is to
maintain or restore movement in the affected joints so that contractures (permanent stiffness) do not occur. Therapists will advise the most effective way to achieve this and also provide advice on how to control other symptoms.
Medication - Painkillers may help you to continue most everyday activities
and to exercise effectively. Medications such as Gabapentin / Amitriptyline are used to control the neurological symptoms.
Pain clinic – Consultant anaesthetists with special interest in Pain
management run these clinics. They can give you better advice on pain management and prescribe appropriate medication. Specific injections may be helpful if the condition is slow to improve.
How long does CRPS last?
Approximately 50% of cases are mild and resolve quickly and without treatment. In more severe cases symptoms may last for up to two years and occasionally longer. www.bostonfoot.co.uk
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