Complex Regional Pain Syndrome

Complex regional pain syndrome (CRPS) is uncommon and the precise cause is not well understood. It may be related to nerve injury or to abnormal inflammatory and sympathetic nervous system responses. CRPS used to be called reflex sympathetic dystrophy (RSD).

There are two recognized types:

• Type I: Occurs without confirmed nerve damage.
• Type II: Follows a clearly identified nerve injury.

Common symptoms include:

• Intense, burning or throbbing pain
• Swelling of the affected limb
• Changes in skin color and texture; skin may appear shiny
• Altered hair and nail growth patterns
• Temperature changes or asymmetry compared to the opposite limb
• Excessive sweating in the affected area
• Reduced mobility or stiffness

Because CRPS symptoms can evolve over time, early specialist assessment (pain clinic, neurology, orthopedics or rehabilitation medicine) and targeted investigations help confirm the diagnosis and guide treatment.

A physician diagnoses CRPS from the history and physical exam; imaging and nerve function tests may support the diagnosis. A sympathetic nerve block can also help confirm the diagnosis and provide temporary relief.

Early multidisciplinary treatment gives the best outcomes. Typical components include:

• Physical therapy — movement and graded exercises to restore function and reduce pain-related disability
• Medications — analgesics, neuropathic pain agents (e.g., gabapentinoids), anti-inflammatory drugs, and sometimes short courses of steroids
• Interventional procedures — sympathetic nerve blocks, pulsed radiofrequency, or other targeted injections
• Neuromodulation — spinal cord stimulation for severe, refractory pain
• Psychological support — cognitive behavioral approaches to manage pain coping and reduce distress
• Multidisciplinary pain rehabilitation — combining therapies for long-term improvement

At Nano Hospitals, our team works across pain medicine, neurology, orthopedics and rehabilitation to create individualized plans aimed at pain relief, restoring function, and improving quality of life.