What is complex regional pain syndrome?

Complex regional pain syndrome is severe pain that may occur after an injury. It usually affects an arm or a leg, but it can occur in other areas of the body also. In rare cases, the syndrome develops after surgery, heart attack, stroke or other medical problem. Often, the pain is described as a burning feeling and is much worse than expected for the injury. Your doctor may also call this condition reflex sympathetic dystrophy or causalgia. The cause of the syndrome is not known.

What are the symptoms of complex regional pain syndrome?

The symptoms of complex region pain syndrome include:

• A painful, burning feeling in the affected area (usually an arm, leg, hand or foot), often long after the time when your injury should have healed
• The affected skin may be tender to the touch, swollen and very sensitive to hot or cold temperatures
• Change in skin color (skin often turns red, blue or white)
• Change in skin texture (skin over the affected area may become thin or shiny)
• Stiffness and pain in the joints
• Muscle pain and weakness
• Loss of mobility in the affected area

How can my doctor tell if I have complex regional pain syndrome?

Your doctor will make the diagnosis based on your pain symptoms and your physical exam. There is not one specific test that can diagnose complex regional pain syndrome. Your doctor may order a test to check skin temperature and how much blood is flowing to a certain area of your body. If there is a major difference in the results between the affected limb and an unaffected limb, your doctor may diagnose complex regional pain syndrome. A magnetic resonance imaging (MRI) test can show changes in the tissue of the affected limb.

Does medicine help?

Yes, medicine can help. Sometimes a combination of medicine is necessary. Several medicines are used to treat the pain of complex regional pain syndrome. Your doctor may suggest that you take an over-the-counter nonsteroidal anti-inflammatory drug (NSAID) to help with pain and inflammation. These medicines include aspirin, ibuprofen (brand names: Advil, Motrin) and naproxen (brand name: Aleve).

If your pain is severe, your doctor may prescribe medicines that block certain nerves. Sometimes steroids help swelling and pain. Some medicines used for depression and seizures also help chronic pain. Narcotics and other pain medicines may not control the pain of complex regional pain syndrome.

Are there other treatments?

Yes. Your doctor may suggest a sympathetic block. This is an injection of an anesthetic (pain reliever) into certain nerves to block the pain signals. If the injection works, it may be repeated.

Physical therapy and psychological counseling are also helpful. However, a treatment that works for one person may not work for another. An individual treatment plan must be made for each person.

Will the symptoms ever go away?

With early treatment, you may keep complex regional pain syndrome from getting worse. Sometimes the condition improves. If treatment is started early enough, the symptoms may completely go away. However, people who have more severe symptoms that have lasted for a long time often don't respond to treatment. These people may benefit from a pain management program aimed specifically at dealing with chronic pain.

• What is the likely cause of my pain?
• If my injury has healed, why am I still in pain?
• Do I need any tests?
• What is the best treatment option for me? Do I need medicine? Physical therapy? Counseling?
• When can I expect relief from my pain?
• Will alternative therapies, such as yoga or acupuncture, help relieve my pain?