What is complex regional pain syndrome?

Complex regional pain syndrome is pain that may occur after an injury to an arm or a leg. In rare cases, the syndrome develops after surgery, a heart attack, a stroke or some other medical problem. The pain is often described as a burning feeling and is much worse than expected for the injury. Your doctor may also call this condition reflex sympathetic dystrophy or causalgia. The cause of the syndrome is not known.

How can my doctor tell if I have complex regional pain syndrome?

Your doctor will make the diagnosis based on your pain symptoms and your physical exam. People with this syndrome still have severe pain long after the time when their injury should have healed. The injured area is often swollen. The color, or the temperature and moistness of the skin may change. The skin may be very sensitive to a light touch or to changes in temperature.

Usually, no tests are needed to diagnose this condition. Your doctor may order x-rays or blood tests to see if another illness is causing your pain.

Does medicine help?

Yes, medicine can help. But no single drug or combination of drugs gives long-lasting relief to patients with this problem. Several medicines are used to treat the pain of complex regional pain syndrome. Medicines that block certain nerves may be prescribed. Sometimes steroids help. Some medicines used for depression and seizures also help chronic pain. Narcotics and other pain medicines may not control the pain of complex regional pain syndrome.

Are there any other treatments?

Yes. Your doctor may suggest a sympathetic block. This is an injection of an anesthetic (pain reliever) into certain nerves to block the pain signals. If the injection works, it may be repeated. Physical therapy and psychological counseling are also helpful. However, a treatment that works for one person may not work for another. An individual treatment plan must be made for each person.

Will the symptoms ever go away?

With early treatment, you may keep complex regional pain syndrome from getting worse. Sometimes the condition improves. If treatment is started early enough, the symptoms may go away completely. However, people with more severe symptoms that have lasted for a long time often don't respond to treatment. These people may benefit from a pain management program that is aimed specifically at dealing with chronic pain.

Websites:

Reflex Sympathetic Dystrophy Syndrome Association of America: www.rsds.org