Complex regional pain syndrome

Complex regional pain syndrome is a painful disease involving swelling, circulatory problems and changes in the skin on the arms, hands, legs or feet. Complex regional pain syndrome can develop during the healing process after an injury or an operation. Treating the disease often poses a challenge for medical professionals. The earlier it is detected, the better the changes of recovery.

Complex regional pain syndrome virtually only develops after an injury or operation on one of the body’s limbs. This disease is also known as reflex sympathetic dystrophy. The exact causes are unknown. However, it is assumed that excessive responses from the nervous system during the healing process play a role in the development of the syndrome. Psychological factors such as stress or difficult personal circumstances also appear to influence the development of complex regional pain syndrome.

The disease typically begins with inflammation in the soft tissue of the affected extremity. This is characterised by pain, swelling, redness and hot skin. As complex regional pain syndrome progresses, the tissue develops circulatory problems and dystrophy. The skin becomes sensitive to the cold, the area often turns blue and is prone to cold sweats. The level of pain increases and the affected joint stiffens. The patient may even completely lose the ability to use the extremity (e.g. total loss of function in the hand).

Complex regional pain syndrome is diagnosed on the basis of the patient’s medical history and the syndrome’s characteristic symptoms. Before a diagnosis can be made, other potential causes – such as lymphoedema or a venous thrombus – must be excluded.

Providing therapy for this syndrome has long posed a challenge for modern medicine. The more advanced the disease, the harder it is to treat. However, if therapy is started early then the patient has a good chance of recovery.

Either way, treatment always consists of a combination of different approaches. These include pain therapy and combating the inflammation with anti-inflammatory medication. Physiotherapy exercises and targeted mobility therapy help to retain mobility in the affected extremity. Treatment often lasts for a very long time and the pain and discomfort are very physically and psychologically demanding. Patience and good psychological support during the therapy are therefore important for the healing process.

Experience has shown that vitamin C and calcitonin can help to prevent the development of complex regional pain syndrome.