Dealing With Complex Regional Pain Syndrome

When my daughter Kayla was 10 years old, she fell on the playground at school. She wasn’t injured, but complained that her leg hurt. We took her to the hospital that night for X-rays, and again, no injury was found, yet the pain continued to get steadily worse. Over the course of the next few days and weeks, the pain worsened, and spread. Eventually it would encompass both of her legs, and reach a level of severity so strong that she could not stand, or even bear to have her legs touched in any way.

We saw several doctors during this time, none of which were able to diagnose her condition. We did however, have doctors who told us that it was a) all in her head, or b) an attempt to get attention. One doctor (Dr. Michael Schmitz of Children’s Orthopedics of Atlanta) even accused my wife of using my daughter as a ruse to obtain prescription drugs fraudulently.

Obviously, this was a strange case, until I heard from a man in North Carolina whose daughter was having the same symptoms. We learned that what we were dealing with was a condition known as Reflex Sympathetic Dystrophy, a chronic pain condition which gets worse over time, primarily affecting the legs and feet, but can spread to the arms and hands.

Now we knew what to call it, but we didn’t know if there was a treatment. What we did know is that it can be triggered as the result of older injuries, and is best described as turning all of your pain receptors on full. The message to your brain is that you are in agony, even though there is no visible injury. The pain, however, is very real. Left untreated, it can become debilitating.

In recent years, the medical community has renamed RSD as Complex Regional Pain Syndrome (CRPS), and from what evidence is available, this is what we know:

While exact causes of CRPS are unknown, there is evidence to suggest trauma to an old injury may be a trigger. Others suspect a “short circuit” in the nervous system that causes over activity of the sympathetic (unconscious) nervous system which affects blood flow in the affected area. Other causes may include pressure on a nerve, infection, cancer, neck problems, stroke, or heart attack.

There are three progressive stages of CRPS:

Stage 1 (Acute) – consists of burning pain and increased sensitivity to touch. The pain is more constant and longer lasting than would normally be experienced with a given injury. Swelling and joint stiffness may occur.

Stage 2 (Dystrophic) – this can last from 3 to 12 months, swelling is more constant, and pain is more widespread. Sensitivity to touch will also increase as the condition progresses.

Stage 3 (Atrophic) – the skin of the affected area becomes pale, dry, and shiny. It also becomes stiff, and there is little hope of recovering full motion. The pain may increase and spread to other areas of the body.

The key to successfully treating CRPS is to treat it early. CRPS does reach a point where it will not respond to treatment of any kind.

It is very important that patients NOT be told that the pain “is all in their heads”. CRPS is a physiological condition, not a psychological one, and it is treatable.

Nonsurgical treatments for CRPS include:

Medications – Non-steroidal anti-inflammatory drugs, anti-depressants, blood pressure medications, anti-convulsants, and opioid analgesics are usually prescribed to treat symptoms.

Injection Therapy – Injecting an anesthetic near the affected area may relieve some of the pain. This is a recommended early treatment to avoid progression to later stages.

Therapy – This consists of active exercise that emphasizes normal use of the affected limb, and is essential to obtaining permanent relief. At first the therapy may be worse than the condition itself (at least it was for our daughter), but the end result is more than worth it.

Surgical treatments may be required if all else fails. Options include:

Spinal cord stimulator – Tiny electrodes are placed along the spine and deliver mild electronic impulses to the affected nerves.

Pain pump implantation – A small device implanted near the abdomen that delivers pain medication to the spinal cord.

Be advised that surgical procedures relating to CRPS are usually less than successful.

The good news is that Kayla was successfully treated by the staff at Sports Medicine of Atlanta in Snellville GA, and as of this writing is four years pain free.

Billy is the Director Of Content for LeadByFone LLC, a lead generation company servicing the water clean up and restoration industry.  He is based in Atlanta, GA