As humans, we are intrinsically hardwired to avoid pain and anything that may cause it thanks to years of evolution. Thus, whenever we experience inevitable issues that cause pain, such as ageing-related back pain, we often seek expert help like from a back pain specialist in Singapore in this case to free us from our discomfort.
What is Complex Regional Pain Syndrome?
Sensory changes: Heightened sensitivity of the affected area to temperature and pressure such as from touching.
Trophic changes: The tissues and skin itself within the affected area may become shiny, grow thin, or develop ulcers.
Motor changes: Issues like reduced range of motion, stiffness, tremors, and muscle weakness may develop.
Autonomic changes: These refer to changes in the body’s automatic functions and cover aspects like sweating, temperature, nail or hair growth, and skin colour.
CRPS Type 1
Formerly known as Reflex Sympathetic Dystrophy (RSD), CRPS Type 1 arises without a clearly identifiable nerve injury. Instead, it typically follows trauma or crush injuries that affect multiple minor nerves, creating a complex and widespread pain response. Symptoms such as swelling, tremors, and changes in temperature and skin colour, often accompany this form of CRPS. While the term “RSD” is no longer in active use, it reflects an earlier understanding of this condition.
CRPS Type 2
CRPS Type 2, previously referred to as causalgia, differs in that it stems from a specific and identifiable nerve injury. This type allows for a more direct link between the symptoms—severe pain, changes in sensation, and other disturbances—and the damaged nerve.
Stage 1: The Acute Phase
Lasting up to three months, this initial stage is marked by severe burning pain that often seems out of proportion to the original injury. Visible signs include swelling (oedema), redness (erythema), and occasional skin inflammation (dermatitis). Despite the absence of bone involvement at this stage, the pain can be incredibly distressing.
From 3 to 6 months after onset, CRPS progresses to the dystrophic stage. Swelling worsens, and the skin begins to thicken. Muscle wasting (atrophy) may set in, accompanied by persistent or escalating pain.
Beyond 6 to 12 months, CRPS enters its chronic stage. This phase is defined by significant functional challenges, including restricted movement, joint contractures, further skin atrophy, and bone demineralisation. While pain may fluctuate, the long-term impact on mobility and quality of life often becomes more pronounced.
Understanding the Spread of CRPS
In some individuals, Complex Regional Pain Syndrome (CRPS) can extend beyond its original boundaries, a phenomenon known as “spreading CRPS.” This can affect the opposite limb or other areas of the body. Although the precise mechanisms remain unclear, they likely involve a complex interaction between the nervous and immune systems.
Comprehensive CRPS Treatments and Therapies
Personalised care is the cornerstone of CRPS treatment, which may involve combining some or all of the following solutions:
Physical and Occupational Therapy
This focuses on restoring strength, mobility, and function through proven techniques like desensitisation therapy, which entails a gradual exposure of the affected area to different textures and temperatures to reduce sensitivity and improve tolerance.Sympathetic Nerve Blocks
Nerve blocks are targeted injections that temporarily obstruct nerve signals, providing significant pain relief, particularly in cases of CRPS Type 1.
Spinal Cord and DRG Stimulation
An advanced set of interventions that involve implanted devices designed to deliver electrical impulses to the spinal cord or dorsal root ganglion, interrupting pain signals for long-term relief.
Psychological Support
Chronic pain impacts mental health, making psychological support essential. Counselling and coping strategies address the emotional toll, helping patients navigate the challenges of living with CRPS.
