CRPS/RSD - What is it, Symptoms, Diagnosis and Treatments
Q: What does CRPS/RSD stand for?
A: CRPS is an abbreviation for the disease know as Complex Regional Pain Syndrome. RSD which is another term for this disease is an abbreviation for Reflex Sympathetic Dystrophy.
Q: What is CRPS/RSD?
A: CRPS or RSD is a disease of the sympathetic nervous system which is a component of the central nervous system.
Q: What are the functions of the sympathetic nervous system?
A: The sympathetic nervous system has three main functions.
- Regulation of body temperature
- Regulation of blood pressure, pulse and respiration
- Regulation of the body’s immune system
Q: How do you get CRPS/RSD?
A: Usually some injury or noxious event, whether minor or major will stimulate the sympathetic nervous system. Normally, the sympathetic nervous system performs its respective functions then shuts down. In the case of CRPS/RSD, the sympathetic nervous system activates, does not shut down, stays on and remains active but in a dysfunctional manner.
Q: How does CRPS/RSD affect the body?
A: Multple ways:
- VERY HIGH LEVEL PAIN to any area of the body, e.g. head, neck, mouth, face, back, shoulder, arm, hands, chest, hips, legs, and feet.
- SWELLING, EDEMA TO ANY AREA OF THE BODY e.g. face, arms, hands, fingers, legs, ankles, and feet.
- MUSCLE SPASMS, TIGHTNESS, TWITCHING to any joint or area of the body, e.g. TMJ, head, neck, shoulder, elbow, wrist, fingers, hips, knees, ankles and toes.
- NUMBNESS, TINGLING SENSATION to any part of the body.
- SKIN ALTERATIONS to include skin blanching red, blanching white, and various rashes with or without itching on any part of the body. These rashes can come and go or stay visible. Also, the skin can alternately feel hot and or cold.
- MOOD ALTERATIONS to include insomnia, irritability, poor focus, poor memory and depression.
Q: Do these symptoms occur all at once or can they occur individually or in combinations?
A: These symptoms can occur individually, in any combination or all at once in any degree of severity.
Q: Is the whole body affected by CRPS/RSD? or can parts of the body be affected?
A: Since CRPS/RSD is a disease of the sympathetic nervous system, it can affect any part of the body including internal organs. The symptoms express themselves in what is known as a thermatomal distribution as illustrated below. Any of the symptoms listed can occur in any combination in one or more of the four color diagramed thermatomal areas.
Q: How is CRPS/RSD diagnosed?
A: CRPS/RSD is diagnosed mainly through proper patient history, clinical observation and examination. The more signs and symptoms of sympathetic nervous system dysfunction present, the greater the suspicion of CRPS/RSD should be and the more likely a diagnosis of CRPS/RSD will be made and confirmed.
Q: How is CRPS/RSD treated?
A: First, all sensory pain which might be keeping the sympathetic nervous system active must be identified, eliminated and or contained.
Then as part of a diagnosis and initial form of treatment, especially when the head, neck and upper body are involved, cervical, sympathetic regional nerve blocks can be given. These nerve blocks are administered in the doctor’s office using the same local anesthetic as that used to treat a toothache. If there is relief of presenting symptoms, (i.e. pain, spasm etc.) obtained from the nerve blocks, usually within about fifteen minutes to one half hour, a diagnosis of CRPS/RSD is confirmed and further treatments can be recommended. These nerve blocks can be repeated in a timely manner if indicated.
Q: What other treatments for CRPS/RSD are there?
A: There are multiple ways to attempt to treat CRPS/RSD and relieve and or eliminate symptoms.
- There are medications that can be prescribed to control and attempt to regulate the sympathetic nervous system as well as manage pain, muscle spasm and inflammation in a non-narcotic manner.
- When any type of muscle spasm or tightness is present physical therapy is very helpful to regain mobility.
- There is a definitive CRPS/RSD diet patients can go on. Certain foods contain chemicals that stimulate the sympathetic nervous system and as such must be eliminated from the CRPS/RSD sufferer’s diet.
- If there are skin irritations and or rashes, Epsom salt baths can be very helpful.
KEY: The most important point to understand when treating CRPS/RSD is that no one treatment works alone. The treatment must be multi-factorial and delivered concurrently.
Q: What is the goal of treatment?
A: To eliminate, minimize and or control as many symptoms as possible and thus restore quality and enjoyment of life.
Q: How bad can CRPS/RSD get?
A: CRPS/RSD actually occurs in four definable stages. These stages are a progression of this disease and can overlap with the later stages showing more severe signs and symptoms of body dysfunction. In the advanced stages of CRPS/RSD, patients can become very sick with minimal and or no ability to fight disease or infection. KEY: EARLY DIAGNOSIS IS CRUCIAL.
Q: Is there a cure?
A: There is no cure for CRPS. However the diagnosis of this disease in its earliest stage does provide the greatest chance for extended remission and abatement of symptoms. With the progression of this disease, repeated, ongoing attempts to control and minimize symptoms, flare ups and relapses thru a multi-treatment approach becomes a more realistic treatment goal. KEY: EARLY DIAGNOSIS IS CRUCIAL.
Q: Once signs and symptoms of CRPS/RSD are controlled, minimized or eliminated, can re-occurrence and or relapse of symptoms occur?
A: Yes. Any new noxious, pain, and or stress producing event that the CRPS/RSD patient is exposed to can cause a flare up of any previous sympathetic nervous system mediated symptoms and or create new sympathetic nervous system mediated symptoms. The CRPS/RSD patient must be aware of this.