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Complex Regional Pain Syndrome (“CRPS”)

Complex Regional Pain Syndrome (“CRPS”) is a long-term or permanent disease that sometimes develops following a traumatic injury, usually to one of the arms, hands or legs.  CRPS is more common following severe injuries, like a complicated fracture or crush injury.  However, it can develop after a more minor appearing trauma, like a sprain from falling on an outstretched hand.

CRPS is diagnosed when pain, loss of strength and limitation in movement, usually in a leg, arm or hand,  persist for months after the initial injury has healed.  The signs and symptoms of CRPS may include one or more of the following:

  • Pain that is out of proportion to the injury;
  • Pain that is burning and stabbing (there may also be numbness and tingling);
  • Color and temperature changes in the extremity, such as blueness and coldness;
  • Swelling that comes and goes;
  • Skin changes such as thickening of the skin, shiny skin or abnormal hair; and,
  • Loss of strength, use, mobility and function of the arm, hand or leg.

The initial injury may or may not involve direct trauma to a major nerve, such as a misdirected injection or botched attempt to draw blood, where the needle pierces a nerve and causes a sudden, severe electric shock sensation.   However, CRPS can develop even where no major nerve has been physically damaged.  In other words, Complex Regional Pain Syndrome can develop from less-severe injuries like bruises, sprains, and bone fractures.

Some medical authorities believe that CRPS is caused by biochemical changes associated with the body’s initial reaction to trauma in the tissues, which then alter and disrupt the body’s nerve cell pain network.   The disrupted pain signaling system sends severe and repetitive pain messages to the brain in response to normally non-painful movements of the affected limb, such as walking or opening a can of soup.  The haywire pain network also may send severe pain signals in response to normally non-painful stimuli, such as unbearable pain from a sheet resting on a foot in bed or wind blowing on an arm.

CRPS is sometimes difficult for doctors to diagnose. Unfortunately, there is no simple test like an x-ray that shows CRPS.  Doctors diagnose CRPS based upon clinical symptoms and ruling out other possible explanations for the chronic pain and disability, such as arthritis or spinal cord compression.  The treatment of CRPS may include medications such as Gabapentin (Neurontin); anti-inflammatory medications; regional nerve block injections; and pain pumps to deliver medication or spinal cord stimulators to interfere with the pain signals.  Early physical therapy and mobilization of the affected limb are key treatments to maximize use of the limb and prevent disability.

For more information on Complex Regional Pain Syndrome, contact the National Institute of Neurological Disorders and Stroke, a division of the National Institutes of Health and the U.S. Government, at:

            If you or a loved one have been diagnosed with Complex Regional Pain Syndrome (“CRPS”), or have persistent problems with pain that following a traumatic injury, contact Neff Injury Law for a free, initial consultation.