Complex Regional Pain Syndrome (CRPS or RSD)
Complex regional pain syndrome (CRPS) – also known as reflex sympathetic dystrophy (RSD) – is a chronic pain syndrome that most often affects one arm, leg, hand, or foot following injury or trauma. CRPS is believed to be caused by damage to, or malfunction of, the peripheral and central nervous systems and presents as prolonged or excessive pain and mild or significant changes in skin color, temperature, and/or swelling in the affected area.
Providers aren’t sure what causes some people to develop CRPS. In more than 90 percent of cases, the condition is triggered by a trauma or injury, such as a fracture, sprain or strain, soft tissue injury (such as a burn, cut, or bruise), limb immobilization in a cast, or surgical or medical procedures. It’s more common in adults; rarely affects children younger than 10; and is not uncommon in teenagers.
The Pediatric Pain Management Center at Children’s Health offers children and parents a specially trained team that evaluates and treats chronic pain, acute pain and headaches. Our interdisciplinary approach involves many other specialties to treat pain using multiple approaches at once. The Center can help lessen the pain associated with a variety of diseases and disorders including, but not limited to, chest and back conditions, nerve injuries, rheumatologic conditions, sports injuries and cancer. We also have a dedicated headache clinic for those children suffering from headaches.
Symptoms of CRPS vary, but the most common symptom is prolonged pain in one area. Your child’s pain may be constant, and can range from mildly uncomfortable to severe. Your child may complain of a burning, squeezing, or “pins and needles” sensation, and pain can spread throughout an entire arm or leg. Your child’s limb may also be sensitive to touch.
Children with CRPS may also experience:
- Constant or intermittent changes in temperature, skin color, and swelling of the affected limb
- Changes in skin over the affected area
- An abnormal sweating pattern in the affected area
- Changes in nail and hair growth
- Stiffness in an affected joint
- Problems coordinating muscle movements
- Abnormal movements – like tremors, jerking, or fixed postures – of the affected limb
Tests and Diagnosis
Your child’s provider will ask about any history of injury or trauma to the area and look for symptoms that match the syndrome. He or she may also order tests to rule out arthritis, Lyme disease, and various muscle and nerve problems.
The Pediatric Pain Management Center at Children’s Health℠ offers many ways to manage pain associated with CRPS. Your child’s providers may recommend one, or a combination of several, of these therapies:
- Pain relievers – over-the-counter or prescription
- Anti-seizure or anti-depressant medications, which can ease neuropathic pain
- Topical creams or patches
- Physical therapy
- Occupational therapy
- Desensitization therapy
- Psychological counseling
- Electrode nerve stimulation
- Lifestyle changes, such as weight loss or activity modifications
- Massage therapy
- Nerve blocks
Is CRPS common in children?
CRPS is most common in adult women, and does not often affect children under the age of 10. However, the condition is not uncommon in teenagers.
What are the symptoms of CRPS?
The key symptom is prolonged pain in at least one arm, hand, leg, or foot. Pain may be constant or come and go, be uncomfortable or severe, and may feel like burning, tingling, or squeezing.
Which treatments will work for my child?
Your child’s providers and team at the Pediatric Pain Management Center at Children’s Health℠ will help design a treatment plan for your child based on his or her symptoms, previous injury or trauma, and response to previous treatments.