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 also occur in other areas of the body. In rare cases, the syndrome develops after surgery, a heart attack, a stroke or other medical problem. The pain is often 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.

The symptoms of complex region pain syndrome include:

Your doctor will make the diagnosis based on your pain symptoms and your physical exam. People who have this syndrome still have severe, often burning pain long after the time when their injuries should have healed. The injured area is often swollen. The color, or the temperature and moistness of the skin may change. The skin may be sensitive to a light touch or to changes in temperature.

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.

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 (NSAIDs) 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.

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.

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.