Complex Regional Pain Syndrome

Complex Regional Pain Syndrome (CRPS) or Reflex Sympathetic Dystrophy is a painful condition usually involving either a lower or upper limb that occurs after an injury or trauma , such as a fracture or sprain. Symptoms vary and may last weeks, months or years. Early diagnosis and intervention is essential for a quick recovery. Interestingly reported more  often in children and teens with pre-existing connective tissue disorders.

Symptoms

• Constant (often burning) pain in the affected limb. Pain starts close to the original injury site but spreads further up the limb if untreated
• Pain disproprotionate to stage of recovery from original injury
• Pins and needles sensation in the area injured and surrounding areas on the limb often in a sock or glove-like distribution
• Child will often keep the affected limb very still (like it is "frozen")
• Muscle wasting from disuse
• Tremors or spasms in the affected limb
• Stiffness of joints in the affected limb
• Changes to the integrity of skin, hair and nails on the affected limb
• Temperature changes in comparison to the other limb (very warm and sweaty or cold/clammy)
• Colour changes during day  in the affected limb compared to the opposite limb ( red/blotchy/white/purple patchy)
• Difficulty weight bearing due pain in the injured limb

Diagnosis

Early diagnosis is vital to prevent delayed recovery (months to years). Seek assessment from a musculoskeletal physiotherapist or Sports Physiotherapist, Gp, or Rheumatologist or Orthopaedic Surgeon for diagnosis

Management

1. Medical Management for evaluation of bone density changes and pain management

2. Physiotherapy Management involves:

• desensitization of the affected limb
• restoration of movement
• weight transference and gait retraining
• restoration of function

Below is a photo on a foot with RSD following trauma to 5th toe:

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