Complex regional pain syndrome - Symptoms 

Symptoms of complex regional pain syndrome 

The main symptom of complex regional pain syndrome (CRPS) is severe, continuous and debilitating pain. It is usually confined to one limb, but can spread to other parts of the body in some cases.

Chronic pain

The pain associated with CRPS is usually triggered by an injury, but is a lot more severe and long-lasting than you would normally expect.

The pain is usually burning, stabbing or stinging, but there may also be a tingling sensation and numbness.

You may have periods of pain lasting a few days or weeks, called flare-ups, where the discomfort gets worse. Stress in particular can lead to flare-ups, which is why relaxation techniques are an important part of treating CRPS.

If you have CRPS, your skin in the affected area can become very sensitive, and even the slightest touch, bump or change in temperature can provoke intense pain.

You may hear this described in the following medical terms:

  • hyperalgesia  extreme sensitivity to pain
  • allodynia  experiencing pain from something that should not be painful at all, such as a very light touch

Other symptoms

In addition to chronic pain, CRPS can also cause a range of other symptoms, including:

  • strange sensations in the affected limb  it may feel as if the affected limb does not belong to the rest of your body, or it may feel bigger or smaller than the opposite, unaffected limb
  • alternating changes to your skin – sometimes your skin may be hot, red and dry, whereas other times it may be cold, blue and sweaty
  • hair and nail changes  your hair and nails may grow unusually slowly or quickly, and your nails may become brittle or grooved
  • joint stiffness and swelling (oedema)
  • tremors and muscle spasms (dystonia)
  • difficulty moving the affected body part
  • difficulty sleeping (insomnia)
  • small patches of fragile bones (osteoporosis) in the affected limb – although there is no evidence this could lead to fractures

Some of these problems can make it very difficult for people with CRPS to move around or travel easily.

Further problems

The emotional strain of living with chronic pain can sometimes lead to psychological problems, such as depression and anxiety. During periods of extreme pain, some people may even consider suicide.

See your GP as soon as possible if you have been experiencing feelings of depression or suicide. They will be able to provide help and support. Alternatively, you can call the Samaritans on 08457 90 90 90. They are available 24 hours a day to talk through any issues that you may be experiencing, and will do so in total confidence.

In very rare cases, CRPS can also lead to further physical complications, such as skin infections and ulcers (open sores), muscle atrophy (where the muscles begin to waste away) and muscle contractures (where the muscles shorten and lose their normal range of movement).

When to see your GP

You should see your GP if you have persistent pain that is preventing you from carrying out everyday activities.

CRPS can be difficult to diagnose, and it's best to seek help as soon as possible, because early can help reduce any unnecessary suffering.

Read more about diagnosing CRPS.

Page last reviewed: 09/05/2014

Next review due: 09/05/2016

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Comments

The 7 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Joton said on 10 January 2014

I broke my wrist in December 2012 and had a plaster cast put on at a local walk-in centre; two days later I attended the local hospital where they re-xrayed and decided to add a fibreglass plaster on top of the original plaster. From that day I began to experience unbelievable pain/burning. I went back to the walk-in several times, and had many hospital visits (some appointments, some unscheduled) and told various consultants/registrars/nurses about the agonising burning but nobody picked up on it. I had the plaster changed three times in all!

Just under 5 weeks after my accident I returned to the hospital yet again begging them to remove the plaster, which they did. I thought it would alleviate the terrible burning pain if I put cream on the areas but it was just as bad.

In the end we paid£450 +x-ray charges to see the head consultant of the hospital fracture clinic privately (I’d only ever seen his registrars) and he immediately diagnosed CRPS, suggesting immediate starting of physio, making sure that on future visits to the fracture clinic I would see him personally. I paid to have twice-weekly physio and stuck rigidly to what I was told to do. Fortunately I did not look up CRPS as I was frightened and depressed enough as it was!

A year later my wrist is still a bit stiff but my range is better than I could have hoped for, and I think it will improve even more. The CRPS pain is all but gone, although there is still some joint pain which I feel is normal. My consultant and physio told me that it was my sheer determination that put me in the top 5% of expected recovery. My sympathy goes out wholeheartedly to anyone suffering from this debilitating condition but there is a light at the end of the tunnel – I am testament to that. I just don’t know why none of the medical staff picked up on it – a brief description of symptoms should be sent to all fracture clinics as early diagnosis is imperative!

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K Mac said on 12 July 2013

I find the omission of other signs alarming. The effect on the autonomic and limbic systems for example. I have hypertension caused by CRPS. I have depression caused by CRPS. I am not alone, weird signs of the conditions tend to be thought of as separate when they are actually part and parcel of CRPS.

I agree with SmudgeyL: CRPS is a systemic syndrome. I find it disappointing that the NHS does not recognise this.

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K Mac said on 08 July 2013

Just to add to my previous post. I have read the bit about atrophy and the "person affected is unwilling to use their limb due to associated pain" is very unhelpful. We are talking about patients and, as NHS Choices is talking about "the most severe cases", about a degree of pain that is unimaginable to most people. Unwilling is a hurtful word and the tone of the statement suggests disability denial when actually the patient who has become one of the most severe cases is likely to be profoundly disabled (in the social model sense of disabled).

Shame the page won't be reviewed until May 2014.

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SmudgeyL said on 17 April 2013

Please note that CRPS is no longer considered to have stages.

That have discovered that CRPS is a systemic condition, which effects the whole body. Speaking 4 years ago, Dr Prager, chair of the IASP's SIG for CRPS: http://www.youtube.com/watch?v=-jLUQpaZKf8

So where are the symptoms of falling, fainting, burred vision, nausea, sleeplessness? These symptoms are recognised in medical literature but they are not getting treated as they do not appear on the NHS list.

Other symptoms patients may incur are "cognition; constitutional, cardiac, and respiratory complications; systemic autonomic dysregulation; neurogenic edema; musculoskeletal, endocrine and dermatological manifestations; as well as urological and gastrointestinal function" See Robert J. Schwartzman's paper "Systemic Complications of Complex Regional Pain Syndrome" . It is scary stuff and these symptoms are just being swept under the carpet and ignored.

Surely it is time that we patients get the legitimacy and treatment we deserve. Ignoring CRPS will not make it go away- it gets worse over time and as Dr Schwarzman notes, 35% of CRPS patients consider their symptoms to be "full body". These patients need dignity- it is not right to expect people to crawl about on hands and knees and let them fall over 6 times a day just because the NHS literature is so badly out of date it doesn't include the symptoms.

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Cgc1234 said on 02 March 2013

After an injury two yrs ago I was finally diagnosed with crps. No medication combinations have helped and now I'm having various other problems as a result of my illness.i am in constant agonising pain in both legs.i have now been referred to Walton neurological and really anxious about what lies ahead for me now.if anyone can give me an idea I wud be very grateful.

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LillyHannover said on 04 November 2011

I have a number of health problems. I have severe arthritis in my right leg and hip. I use a cane or walker most of the time. I'm on oxygen 24 x 7 for C.O.P.D., and I have been fighting with depression for 20 years. And I'm in so much pain at night that I'm up and down all night. My doctor put me on morphine 12 hour caps. Any suggestions of a friend or doctor?

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LillyHannover said on 04 November 2011

I have a number of health problems. I have severe arthritis in my right leg and hip. I use a cane or walker most of the time. I'm on oxygen 24 x 7 for C.O.P.D., and I have been fighting with depression for 20 years. And I'm in so much pain at night that I'm up and down all night. My doctor put me on morphine 12 hour caps. Any suggestions of a friend or doctor?

Report this content as offensive or unsuitable