Early Intervention Enhances Recovery for Patients With Chronic Regional Pain Syndrome

Early detection and effective treatment of complex regional pain syndrome (CRPS) can lead to recovery within 18 months, based on the authors of a study led by Neuroscience Research Australia’s Centre for Pain IMPACT at the University of South Australia. The findings challenge the notion that CRPS is a lifelong burden, offering the potential of recovery for impacted patients.

Severe and long-lasting cases of CRPS can be debilitating, greatly affecting an individual’s ability to engage in their usual activities, social events, or work. Image Credit: © Pixel-Shot - stock.adobe.com

CRPS is a rare, severe, multi-system pain disorder that is largely misunderstood in the medical community and has been considered a lifelong, incurable condition. The cause of CRPS is unknown, but it often develops in response to injury, trauma, or sometimes surgery, especially in times of increased emotional stress. CRPS is characterized by intense pain, which is often worse than the original injury, swelling, decreased mobility, and temperature and skin changes that affects the limbs.¹

Existing research into CRPS theorizes it may be a disorder of the immune system that interrupts the nervous system, producing inflammation of the nerves that regulate blood flow, temperature, and sensation. The standard-of-care of CRPS is focused on relieving symptoms to slow disease progression through treatment with medication, physical therapy, talk therapy, as well as more invasive options such as injectable anesthetics, sympathetic ganglion blocks, spinal cord stimulators, or surgery.¹

CRPS has 3 stages of development: stage 1, which is characterized by severe burning or aching pain, fluctuations in skin temperature, rapid hair and nail growth, muscle spasms or joint pain, and changes in skin appearance; stage 2, a period of 3 to 6 months in which symptoms progress and worsen; and stage 3, when muscles and tendons atrophy because it is too difficult or painful to move. Additionally, CRPS is subcategorized into 2 types: type 1 develops without known nerve damage, while type 2 is the result of specific nerve damage.¹

The study assessed a compilation of research from the past decade and revealed new insights into CPRS epidemiology, pathophysiology, diagnosis, and treatment. It supports current standard-of-care treatments but emphasizes the impact of early intervention and subsequent renewed hope for patients. The authors identified the significance of early diagnosis in determining outcomes for patients with CRPS, noting that 80% of patients recovered within the first 18 months of diagnosis. By combining education, pain management medications, physical rehabilitation, and psychological support, clinicians can tackle the diverse symptoms associated with CRPS from multiple angles, giving patients the chance of recovering within the first 12 to 18 months of symptoms.^2,3

The study authors’ findings underscore the need for a deeper understanding of CRPS to enhance clinicians’ knowledge of the disorder and expand patient treatment options. Severe and long-lasting cases of CRPS can be debilitating, greatly affecting an individual’s ability to engage in their usual activities, social events, or work. Addressing these challenges through continued research and education is essential for improving the quality of life for those affected by CRPS.

REFERENCES

1. Complex Regional Pain Syndrome (CRPS). Stanford Medicine. Accessed July 8, 2024. https://med.stanford.edu/pain/about/chronic-pain/crps.html#:~:text=Complex%20regional%20pain%20syndrome%20(CRPS)%20is%20a%20severely%20disabling%20condition,and%20changes%20in%20the%20skin.
2. Complex regional pain syndrome treatment shows promise for recovery. News-Medical. May 6, 2024. Accessed July 8, 2024. https://www.news-medical.net/news/20240506/Complex-Regional-Pain-Syndrome-treatment-shows-promise-for-recovery.aspx
3. Ferraro MC, O'Connell NE, Sommer C, et al. Complex regional pain syndrome: advances in epidemiology, pathophysiology, diagnosis, and treatment. Lancet Neurol. May 2024. doi:10.1016/S1474-4422(24)00076-0