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CRPS

Updated: Jun 1




CRPS – the basics about the condition

Complex Regional Pain Syndrome (CRPS), formerly known as Reflex Sympathetic Dystrophy (RSD) is a poorly understood condition where a person experiences persistent severe and debilitating pain.



Although most cases of CRPS are triggered by an injury, the resulting pain is much more severe and long-lasting than normal and usually the pain persists long after any orthopaedic or objective injury has healed.



Diagnostic tools


According the McGill pain scale (commonly used medical tool for assessment of pain), CRPS can register a pain response of 45/50 compared to natural childbirth of more like 25/50.



Spreading from limb to limb


The pain usually only affects a single limb, but it can sometimes spread to other parts of the body. Incidents CRPS spreading vary from patient to patient but it is thought the risk of spreading is around 5%. Where surgery is required post development of CRPS the risk of spreading is increased significantly.



Common complaints/ signs


The skin of the affected body part can become so sensitive that a slight touch, bump or even a change in temperature can cause intense pain. Our clients talk about being human barometers, knowing long before the weather changes that it is going to rain and despite keeping heating at home at a constant, suffer extreme flair ups when the temperature drops outside.


Vibrations from household appliances like a hoover or a tumble drier can trigger a flare up and so inevitably trips away from home or exposure to crowded or noisy areas are a potential nightmare for CRPS sufferers.


Affected areas can become swollen, stiff or undergo fluctuating changes in colour or temperature, sometimes burning hot and at other times freezing cold. Sweating, unusual hair growth, shiny or poor condition skin are just some of the objective signs of the condition.


Often the symptoms of CRPS result in disuse atrophy which is when the muscles of the affected limb shrink and become weak. Often the lack of use can cause stiffness but use of the limb results in severe pain, so a catch 22 scenario. Muscle spasms and cramps are thought more likely to be the result of muscle atrophy through disuse than directly a symptom of CRPS.


CRPS can gradually improve over time and sometimes people can go into remission, usually following intensive successful treatment. Without effective treatment and sometimes even following excellent treatment, some people with CRPS experience pain for many years impacting on numerous aspects of their day to day lives. Due to constant pain, sleep deprivation and mental illness (adjustment disorders, anxiety and depression) secondary to pain CRPS is often a bar to people accessing the workforce.



Diagnosing CRPS


Diagnosing CRPS can be difficult because it involves having tests to rule out other possible causes. Sadly the symptoms of CRPS are often missed or misdiagnosed. The Budapest criteria is still the most commonly used tool for diagnosis of the condition, but it is far from a perfect tool.

Patients are tested against four lists of criteria A-D. Category A simply requires the patient to exhibit a disproportionate pain response to any inciting event and category D requires there to be no other condition that better explains the signs and symptoms. Categories B and C deal with the specific objective signs and at least one of which needs to be observed.



Type 1 or Type 2


Type 1 CRPS is where there is an absence of definable nerve injury and type 2 CRPS develops after a nerve injury, also known or referred to as causalgia.



Treating CRPS


There is no known cure for CRPS, but there are a number of treatments that can help manage the symptoms.

The 4 main types of treatment offered on the NHS are:

  • education and self-management

  • physical rehabilitation – to help manage your symptoms and reduce the risk of long-term physical problems

  • pain relief – medication to help reduce pain

  • psychological support – treatments to help you cope with the emotional impact of living with CRPS, such as cognitive behavioural therapy (CBT)

The above treatments are best sought as part of a multimodal multidisciplinary pain management programmes (PMP), at centres like the RNHRD in Bath, the Hospital of St Cross in Rugby or the Walton Centre in the North West.

Additional treatments are available on the NHS or if not privately including topical treatments like lidocaine slow release patches and topical creams such as Capsaicin.


There are also more invasive treatments such as nerve block injections and spinal cord stimulators which can prove effective in bringing about a step change in the pain response.

Ultimately in extreme circumstances amputation can be considered, however phantom limb is a concern, such that someone may continue to experience pain in the absence of the limb. CRPS patients often experience disassociation with their injured limbs, such that amputation is commonly requested by them. Amputation is of course complex from a surgical perspective and patients require intensive psychological support in order to prepare for such a procedure.



Why FT Chronic Pain Solicitors?


At FT Chronic Pain Solicitors, we’re nothing like any other firm and are second to none! We have taken the decision to focus entirely on chronic pain conditions because we are specialists in this complex area of personal injury litigation.

We have acted for many clients with CRPS and other severe neuropathic pain conditions such as fibromyalgia. We understand how hard living which such a condition can be. Our passion for helping victims of chronic pain will become immediately clear to you upon instructing us.


We will come to your home to see first-hand what problems you are facing and will then set about ensuring that we tackle each challenge you face as well as securing the financial support you need to meet your outgoings.


At FT Chronic Pain Solicitors we have secured millions of pounds in compensation for victims of accidents which weren’t their fault. We are a small and perfectly formed team with one thing in mind, helping our clients get their lives back.


Feel free to call us, it may be the best call you ever make 0800 999 1078 or email either anne.felmingham@ftchronicpain.co.uk or paul.turner@ftchronicpainsolicitors.co.uk


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