Complex Regional Pain Syndrome
(CRPS) is a chronic pain disorder that afflicts the arms, hands, legs, or feet – the extremities. CRPS can be categories into CRPS Type I and CRPS Type II
. CRPS Type I occurs as a result of a traumatic injury (or a surgery). CRPS Type II, on the other hand, is associated with a nerve injury.
CRPS directly affects the nervous system
, which consists of the Central Nervous System and the Peripheral Nervous System. The Peripheral Nervous System essentially connects the Central Nervous System to the rest of the human body; the Peripheral Nervous System can be further categorized into the somatic nervous system and the autonomic nervous system. Further the autonomic nervous system consists of the parasympathetic system and the sympathetic system.
CRPS is a result of irregularities with the sympathetic system. The sympathetic system regulates the body’s flight-or-flight. Essentially, the sympathetic system allows the human body to quickly respond under acute stress – it increases heart rate, breathing rate, and blood flow (to muscles) among other things. As mentioned above, CRPS is directly related to the sympathetic system. In people with CRPS, the sympathetic system constantly sends pain signals (even without a valid reason) resulting in the constant pain experienced by those diagnosed with CRPS.
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CRPS affects people in three different stages. The first stage of CRPS can last one month to three months
and be accompanied by the following: severe burning/aching that worsens with light touch (or even light breeze); fluctuation in skin temperature (hot and cold); increased sweating in affected area; increased hair and nail growth; joint pain; muscle spasms; changes in appearance, color, and skin texture of the affected area. The second stage of CRPS can last three months to six months
and is typically accompanied by the following: cracked and brittle nails; more obvious changes in the skin; weakening muscles; stiffening joints; increased pain. By the third stage of CRPS
, there is atrophy in the muscles and tendons causing difficulty in using the extremity and (possibly) clawing; these effects of CRPS could be permanent.
The Budapest Criterion
Many conditions can be easily diagnosed with a few tests. CRPS, however, is not one of these conditions. There is no way to effectively test whether a person has CRPS; therefore, diagnoses must be made using the Budapest criterion. The Budapest criterion can lead to a diagnosis of CRPS under the following circumstances: