Complex regional pain syndrome (CRPS) is a term characterised by chronic
persistent pain. CRPS can affect any part of the body, but mainly occurs in the arm
or leg following injury and often involves certain changes to the area including
extremely sensitive skin, reduced function in the hand or foot, redness, warmth,
swelling, and changes to the way nails and hair grow. The onset is mostly
associated with a trauma, surgery or immobilisation however there is no link
between the severity of injury and subsequent CRPS.
What causes CRPS?
It is not clear what causes CRPS however once triggered changes occur in the way
the nerves function. Nerves that carry motor information (nerves that drive
movement), sensory information (nerves that drive feeling and touch) and those
that play a role in other functions including blood flow, which affects temperature
and colour changes within the skin can be affected. This can often lead to weakness
Who gets CRPS?
CRPS affects approximately 5 out of every 100,000 people with a female to male
ratio of 3.5:1. The lower limbs are generally more affected than upper limbs with
the leg affected in 60% of cases and the arm in 40%.
The diagnosis of CRPS is not based on a single test with a black and white result
however there are a range of symptoms that may lead to the diagnosis of CRPS.
● Constant pain, higher than the normally perceived pain
● Extremely sensitive skin eg painful to gentle touch or numbness
● Temperature changes eg sweating or extremely cold
● Skin colour changes eg blotchy, pale, red, blue
● Reduced or painful range of motion
● Changes in hair and nails
Treatment for CRPS
There is no simple treatment for CRPS and treatment will often involve a number of
different modalities with the aim to restore movement and function of the affected
limb and reduce pain. Some common treatment approaches include:
● Physiotherapy – often involves patient education surrounding pain, manual
therapy techniques to improve range of motion and most importantly
exercises to improve the strength and functioning of the affected limb.
● Pain relieving medications.
● Psychological support – to help cope with stress, sleep disturbances and