Overlapping Condition
Complex Regional Pain Syndrome
The only medical condition with complex as its first word.
O
ne of RSDSA’s best selling
t-shirts described RSD thus,
If Hell were a clinical medical
condition, it might look something like Reflex Sympathetic
Dystrophy or RSD, a truism
which too frequently can become
a reality for some of the 50,00075,000 Americans who develop it
annually.
RSD
now known as Complex Regional Pain
Syndrome (CRPS) Type 1 and
2 is a poorly understood and
frequently hard-to-treat neuroinflammatory syndrome characterized by intense chronic pain. It
primarily affects girls and women
(4-1 ratio) and is generally
caused by trauma e.g. fracture,
sprain, and surgery.
I
nitially for individuals who develop CRPS, a diagnosis can be
elusive as there is no gold diagnostic standard. It is a diagnosis
by exclusion. Physicians must
perform a physical exam and
review of medical records. Most
physicians do not learn of CRPS
in medical schools. CPRS can
behave like a chameleon; symptoms wax and wane often within
minutes. During the acute phase,
the tell-tale signs and symptoms
include abnormal sweating of the
affected area, pain (out of proportion to the initiating event)
described as deep, aching, cold,
burning, or stabbing, abnormal
skin color changes, abnormal
swelling in the affected area, pain
(moderate to severe) associated
with allodynia (pain from something that should not cause pain,
such as the touch of clothing, a
shower, breeze), and abnormal
skin temperature.
T
he goal of treatment is to
modify the pain and restore
function. CRPS is best treated
in an interdisciplinar y manner. However, most individuals
must build their own treatment
team as pain care in America
is delivered in a piecemeal,
fragmented fashion. Treatment
is frequently complicated and
delayed by insurance battles as
most medications for CRPS are
off-label or considered “experimental” and most physical
and occupational therapists
have not received instruction
in implementing a functional
restoration protocol.
T
o learn more about CRPS and
the Reflex Sympathetic Dystrophy Association, please visit
www.rsds.org/index2.html.
R
SDSA’s mission is to provide
support, education, and hope
to all affected by the pain and
disability of CRPS/RSD while we
drive research to provide better
treatment and a cure.
F
or treatment guidelines,
please visit http://www.rsds.
org/pdfsall/CRPS-guidlines-4thed-2013-PM.pdf
Written by James W. Broatch,
MSW, Executive Vice President,
Director, Reflex Sympathetic
Dystrophy Syndrome Association
“Consider, too, that in publicizing RSD, we generally focus on the pain, not the disabilities that
come with it—the legs and hands that no longer work, the bones that become osteoporotic,
the joints that become locked, the muscles that become spastic…There is an awful lot we leave
out—how a productive member of society can become too disabled to work or take care of her
children. We don’t discuss the tremendous personal losses—families, friends, jobs—that RSD
wreaks…” (Linda Lang, author, RSDSA board member, and a woman who has suffered with RSD
for nearly 20 years)
30 Fibromyalgia & Chronic Pain
Life
Winter 2014