Complex Regional Pain Syndrome

By Paul A. Friedlin, OTR, CHT

Complex Regional Pain Syndrome (CRPS)

What is Complex Regional Pain Syndrome?

The quick answer, CRPS is chronic pain from an event, injury, surgery, or fracture that affects an extremity. CRPS is more common in women than men.  It most often affects the hand.

Image of woman with pain in her hands

CRPS most often affects the hand

  There are two types of CRPS:

  1. CRPS 1 presents with no apparent nerve injury after an illness or injury such as a broken bone, a stroke, or even a heart attack.
  2. CRPS 2 presents with distinct nerve injury or malformation of nerves.

Two types of CRPS can be attributed to an illness or injury. The precise cause is unknown. Watch this VIDEO on Nerve Conduction Study, a noninvasive technique for diagnosing nerve damage.

  • Each case can vary from mild to severe, and short duration to long duration.
  • Primary symptoms include burning, numbness, pins and needles, changes such as feeling very cold, changes in your skin color, sweating in the painful arm/leg too much or less than your other arm/leg, soft tissue contractures and joint contractures with severe pain.
  • May include both upper or both lower extremities. Skin changes include temperature, skin color, shiny appearance and thin appearance.
  • Arms, hands, legs and feet typically always present with varying degrees of swelling.
  • Joints of the affected extremity are affected with joint stiffness and pain.
  • Abnormal muscle movements can be affected extremity. These include tremors, jerking, and poor to no movement.
  • Skin and nail changes can present with varying degrees.

Read this ARTICLE to learn more about hand pain.


What are the Triggers that Cause CRPS?

Cause of injury can vary widely to include trauma, cuts, burns, fractures, needle sticks, sprains, and soft tissue injuries, or bruises.

  • Prolonged immobilization and/or tight casting/splinting/bracing of the injured extremity can play a role in development of CRPS.
  • Upper/lower body limb such: as a fracture or surgery followed by immobilization by a cast, is the most common cause of CRPS.
  • Nerve adherence from abnormal swelling progresses to nerve gliding issues within the affected extremity.
  • This nerve gliding issue is the primary trigger that continues the sympathetic nervous system response.
  • The most common symptoms are burning, squeezing sensation, pins and needles and numbness.

Is There a New Treatment for Complex Regional Pain Syndrome?

  • Currently is no cure for CRPS, physical therapy is the most imperative treatment.
  •  MPS (Microcurrent Point Stimulation) pain therapy using Dolphin Neurostim units.  To reduce sympathetic stress to reduce soft tissue pain.
  • Dolphin applies brief concentrated DC micro-impulses to key neurological points (called MPS Therapy) that reduce nervous system stress to relax muscles and relieve pain.
  • Can be treated using MPS and manual therapy to the spine and peripheral nerves.  This increases nerve function within the affected limb.
  • With early diagnosis and treatment, average results are 70-85% return of function.

Where Can You Find Pain Therapy Treatment for CRPS?

Image of Occupational Hand Therapy of hand for CRPS

Occupational Hand Therapists at JOI treat CRPS

Referring physicians can refer directly to JOI Beaches Rehab for OT/PT.

By: Dr. Robert David Graham & Paul A. Friedlin, OTR,CHT.

To schedule an appointment  call 904-JOI-2000, visit or click below:

Book An Appointment with a JOI Physician

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