Complex regional pain syndrome (CRPS) is an umbrella term for pain that is disproportionate to the injury that caused it: pain that lasts longer than it should and is excessive for the severity of the injury. CRPS, which occurs in two types: Reflex Sympathetic Dystrophy (Type I), and Causalgia (Type II), can be acute or chronic. Some cases of CRPS eventually abate, but with some patients the condition progresses. The progression of RSD may take several different courses and is difficult to predict because of the absence of obvious nerve damage.
CRPS is characterized by excessive pain from stimuli, severe pain, swelling near the injury site, and changes in the skin. It often affects an arm and/or leg and may spread to another part of the body. RSD is associated with dysregulation of the central and autonomic nervous systems, which can result in limited function of the limb, impairment and disability.
Causes of Reflex Sympathetic Dystrophy
Reflex Sympathetic Dystrophy is an enigmatic condition. In fact, only 1 out of every 10 cases is associated with known nerve damage at the injury site. Where nerve damage is present in CRSP, it’s referred to as Causalgia. In 90 percent of CSRP cases, though, there’s no known associated neuropathy. This body of Chronic Regional Pain Syndrome is what we refer to as Reflex Sympathetic Dystrophy.
RSD is thought to be caused by irregular nervous system reactions to physical stimuli, meaning the nerve tissues overreact on an extreme level to normally harmless stimuli. While its exact mechanisms aren’t yet well-grasped, we do know a characteristic sign of RSD is nervous tissue sending the brain chemical signals to inflame the site of injury unnecessarily.
There are certain things that can trigger RSD, all of which contribute to damage or dysregulation of the nervous system and/or cardiovascular system. Some of these triggers include:
- Injury
- Surgery
- Brain disease
- Heart disease
- Entrapped nerves
- Barbituates
Common Symptoms of CRPS & RSD
Whether or not there actually is nerve damage or neuropathy at the site of the injury, symptoms of Chronic Regional Pain Syndrome mimic signs of nerve damage regardless. Symptoms of CRPS that might present near the site of the injury include:
- Swelling
- Burning or itching pain
- Sharp, shooting pain
- Changes in skin color and temperature
- Restricted movement of the affected limb
- Pain that is continuous
- Bone degeneration
Pain symptoms can often be exacerbated by adverse emotional states or high stress levels. Sometimes even moving or touching the affected limb is excruciating. What used to be thought of as stages of Regional Sympathetic Dystrophy, now known as variants of Chronic Regional Pain Syndrome Type I, are:
Acute: The pain and function symptoms last 1 to 3 months, and is most often characterized by burning sensations, skin changes and muscle spasms. RSD is detectible at this stage as X-rays show small patches of thinning bone tissue.
Subacute/Dystrophic: Symptoms last 3 to 9 months, and most often includes constant pain, increased skin changes like thickening and color changes, and edema growths. Muscles in the affected area begin to weaken, and you may notice your hair and nail growth slows dramatically.
Chronic/Atrophy: Symptoms persist more than 9-12 months, or indefinitely. Chronic symptoms leads to muscle tissue weakness persistent enough to cause atrophy and tissue contraction. If left untreated, the damage becomes irreversible.
Treatment for Chronic Pain with Regenerative Medicine
At the Blatman Health and Wellness Center, our goal is not only to treat and relieve your Reflex Sympathetic Dystrophy symptoms, but resolve the problem causing your pain.
Almost all cases of RSD follow from a significant injury to fascia followed by immobilization. We have the most success treating RSD by working with what has followed from the original fascia injury.
Regenerative treatments for myofascial pain include stem cell therapy, PRP treatments and trigger point injections. These therapies treat the painful area in a way that catalyzes the body’s healing processes. Chronic pain treatments like stem cell therapy have the potential to repair damaged tissue at the affected area.
Dr. Blatman is also credentialed to recommend medical marijuana for pain in Ohio. When managing chronic pain, you have to think long-term. And with pharmaceuticals, the health risks of long-term use abound. But treating pain symptoms with medical marijuana helps alleviate the pain as well as the stress it causes, without risks of complications like organ damage. Let our chronic pain specialists help to unlock the source of your pain and work towards eliminating the cause.
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