Kaiser Permanente - I Have complicated Regional Pain Syndrome? What is it?
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Complex Regional Pain Syndrome (Crps)-ever hear of it? It's more common than one might think. I hadn't until I was diagnosed with it. And the whole thing started with breaking my foot!
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Crps, the cause is unknown, but may be related to a question inspiring the sympathetic nervous system. This law is located along the spinal cord, controls obvious bodily functions-most notably the occasion and end of the blood vessels and sweat glands.
It's known as several other names: Reflex Sympathetic Dystrophy Syndrome (Rsds), causalgia, Sudeck's atrophy and shoulder-hand syndrome. Although it also hits the feet, as it has done with me.
The syndrome occurs as a follow of injury to nerves, bones, joints-occasionally muscles, ligaments or tendons. It can arise from anyone from something as minor as a sprain or, as in my case, a couple of broken bones. In about 25% of sufferers, there is no cause at all.
What are its symptoms? How is it diagnosed and treated? Is it curable?
These questions were swimming in my head. Here are the answers as relayed to me by my rheumatologist, Dr. Randy Lehmer, Head of Rheumatology for Kaiser-Permanente Orange County, along with facts gathered from the Arthritis Foundation and WebMd.com:
The course of Crps has 3 overlapping stages:
Stage 1, the affected area is painful, tender and swells. There are changes in skin color (flesh tone to purple, in my case), sweating, abnormal hair and nail increase and stiffness.
Stage 2, persistent aching/burning/numbness and tingling-sometimes all at the same time! Changes in room/weather temperature, breezes, air-conditioning or even texture changes and movement from garments. Nails become brittle, skin may look waxy. X-rays will show thinning of the bones. Pain starts to spread and muscle spasms start occurring. This is presently where I am.
Stage 3, Permanent changes may form if the outpatient doesn't get help. Joint and limb function are reduced.
According to Dr. Lehmer, my foray into this syndrome probably happened due to the fact that I also have rheumatoid arthritis, although it was not the cause of the accident. Because my foot had to be in a non-weight bearing cast for over two months, the nerve endings decided that this wasn't what they conception should happen in my body and, basically, took over.
Turns out early detection is best (as with most syndromes) for any possibility for perfect recovery. I had been complaining to the orthopedic in fee of my foot, but he assumed (wrongly) that I just needed to keep working at getting my mobility back.
After 6 months I was still having muscle spasms throughout the day and night, pain in the area, deadness and what felt like hot oil running down my leg from my knee down.
I mentioned all this to Dr. Lehmer at one of my quarterly appointments with him-he took me seriously. He ordered up a bone flow scan, new x-rays and consulted with the head podiatrist. Then he sent me direct to bodily Therapy. I was also put on a month-long course of prednisone and told not to feel the pain, as that could absolutely slow down the saving time. If there was to be one. He hoped that I would once again be power walking, but when he was unsure.
Turns out Crps is not curable. With early intervention and permissible care the chances of it being permanent may lessen, but not necessarily will it preclude it from worsening. It seems to be a "play it by ear" type of problem.
Some citizen recovery, some citizen do not.
How are most cases treated? bodily therapy, pain killers, numbing agents (anything from local anesthetic to epidurals), muscle relaxants, short-term steroid use. Some severe cases might use transcutaneous electrical nerve stimulator (Tens) unit or biofeedback. Tens is a small, battery-operated gismo that can ease pain by blocking nerve impulses.
The most important thing with this syndrome seems to be early determination and getting treatment, which may also be the most difficult part. Take the medications and do the exercises that have been prescribed, religiously. It may not be curable, but there is a great deal that can be done to help to help those who suffer with it to live more conveniently and, in turn, be able to lead active fulfilling lives.
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