It is an often misunderstood injury that might take months to manifest itself after an accident, but has been ranked worse on the McGill Pain Index than unprepared childbirth. It is a condition that can cause pain so bad, some patients would prefer amputation of affected limbs. It is known as Complex Regional Pain Syndrome, or “CRPS” for short.
This condition intensifies the symptoms that a victim suffers and may seem disproportionate to the underlying injury. For this reason, wrongdoers and insurance companies may try to deny or minimize claims that involve Complex Regional Pain Syndrome, arguing that the accident could not have possibly caused the symptoms the victim is claiming.
What Is Complex Regional Pain Syndrome?
CRPS is a painful condition that is characterized by extreme pain, swelling, limited range of motion, and changes to the skin, hair, and nails. One of the reasons that CRPS is often misunderstood is because the pain is so disproportionate to the injury that it defies common sense. Some studies suggest that 90% of the time, this central nervous system injury occurs even though there is no study that can confirm an obvious injury to a nerve, although almost all cases have some type of precipitating injury that leads to CRPS.
Symptoms of Complex Regional Pain Syndrome
Because the condition has historically been relatively rare, for a long time only a handful of medical experts existed who had meaningful experience treating the condition. This meant that all too often, CRPS was being underdiagnosed. As a result, some of the world’s top medical experts met in Budapest in 2003, developing what is now known as the “Budapest Criteria” for diagnosing CRPS. The Budapest Criteria remains the gold standard for diagnosing CRPS..
The symptoms of CRPS and their severity vary by each person. However, some symptoms commonly associated with CRPS include:
- Chronic pain, which can be constant or intermittent, burning, throbbing, or stinging
- Numbness
- Skin swelling
- Sensitivity to touch
- Damage, swelling, or stiffness to the joint
- Decreased function in the affected limb
- Loss of muscle tissue
- Muscle spasms
- Changes in skin color, texture, and temperature
- Changes in nail and hair growth
- Changes in sweating patterns in skin
A good prognosis is possible if CRPS is caught early and treatment started, however, all too often CRPS is not caught early enough. Medical literature reports that if not caught within the first few months, CRPS can spread throughout a limb, sometimes affecting opposite limbs as well. One report from Johns Hopkins, indicated that CRPS spread in 77% of cases. In such situations, future care and treatment can be involved, expensive, and ongoing.
Causes of Complex Regional Pain Syndrome
According to the Cleveland Clinic, researchers are not certain as to why some people develop Complex Regional Syndrome while others who suffer similar injuries do not, but in about 90% of cases, CRPS results after nerve trauma or injury to the affected limb. This condition sometimes develops after a person suffers injuries such as:
- Bone fractures
- Splintered bone
- Penetrating injuries
- Crushing injuries
- Sprains
- Strains
- Burns
- Bruises
- Cuts
- Surgical incisions, stitches, or scarring
Additionally, CRPS can develop even without an underlying injury due to prolonged immobilization.
Medical Treatment for Complex Regional Pain Syndrome
There is currently no cure for Complex Regional Pain Syndrome. Treatment is often multi-faceted and focuses on restoring movement and function of the affected limb, relieving pain, and managing symptoms. Some types of treatment that may be used include the following:
- Physical therapy – Physical therapy may incorporate exercises to reduce pain and swelling. The next stage may focus on strengthening muscles and improving the functioning of the limb and then focusing on improving the functioning of the person’s whole body. Treatment can help manage your symptoms and reduce the risk of long-term complications.
- Intervention therapy – Nerve blocks may be used to minimize the pain.
- Implant therapy – In some cases, an electrode or a medication-delivery system is surgically implanted in the victim. This device helps manage the victim’s pain and other symptoms.
- Medication – The victim may be prescribed pain-relieving medications or epilepsy or depression medication.
- Mental health support – Psychological support may be provided to help the victim cope with the stress and emotional impact of living with this condition.
It is not uncommon for several healthcare professionals to be involved with a victim’s treatment.
Types of Complex Regional Pain Syndrome
There are two types of CRPS and several stages of the condition.
Type 1
Type 1 CRPS does not involve a direct nerve injury and usually follows an illness or other injury.
Type 2
Type 2 CRPS follows a distinct nerve injury.
Both types of CRPS involve the same stages of the disease and symptoms.
Stage I
Stage I is acute and may last up to three months. The following symptoms are associated with this stage of the condition:
- Burning pain
- Pain that is more constant and longer-lasting than would normally be expected from the injury
- Increased sensitivity to touch
- Joint stiffness
- Swelling
- Redness in the affected limb
- Increased sweating
- Rapid hair and nail growth
- Muscle spams
- Changing skin temperature from hot to cold
- Changes in the skin’s color, texture, or appearance
Stage II
Stage II, or the dystrophic stage, usually lasts from three to twelve months. Common symptoms during this stage of the disease include:
- More widespread pain
- More constant swelling
- Cooler skin temperature
- Disappearance of skin wrinkles
- Increased stiffness
- Weakened muscles
- Brittle and cracked fingernails
- Affected area becomes even more sensitive to touch
- Skin continues to change
- Hair growth slows down
Stage III
Stage III is the atrophic stage and may occur after one year. Possible symptoms include:
- Decreased pain
- Condition spreads to other parts of the body
- Increased stiffness
- Skin appears pale, dry, stretched, and shiny
If the victim has not received treatment for the condition up to this point, it may not be possible to move the affected limb and damage could be permanent.
Contact an Experienced Personal Injury Lawyer for Help with Your Claim
If you are suffering chronic pain or from Complex Regional Pain Syndrome, a personal injury attorney from Rapoport Weisberg & Sims P.C. can help. We can work with your medical providers and ensure you meet with healthcare providers who can properly diagnose all of your conditions. We can also account for the full extent of your damages when we negotiate for full compensation on your behalf. Call us today to learn more about how we can help with your claim.
You Are Not Alone
Those suffering from CRPS caused by the negligent conduct of another should do everything they can to have a CRPS focused team fighting for them. They should also know that they are not alone. Support groups exist, such as the Reflex Sympathetic Dystrophy Syndrome Association (RSDSA), whose website is http://www.rsds.org. Founded in 1984, the organization promotes patient advocacy and serves as a network for patients to share their common experiences with each other.
Complex Regional Pain Syndrome FAQs
Here are some of the most frequently asked questions we receive about Complex Regional Pain Syndrome:
When Should I See a Doctor?
If you were involved in a personal injury accident such as a car accident, fall, or workplace injury and are experiencing persistent pain that is affecting a limb and making it difficult to carry out everyday activities, you should see a doctor. Be sure to mention the accident and the onset of your symptoms. It is critical to your treatment to treat CRPS early because it can help reduce your pain and possibly prevent permanent damage.
How Common Is Complex Regional Pain Syndrome?
According to the Cleveland Clinic, about 200,000 people in the United States are affected by Complex Regional Pain Syndrome every year.
Who Is More Likely to Suffer from Complex Regional Pain Syndrome?
Adults are more likely to suffer from Complex Regional Pain Syndrome than children. The peak onset for this condition is approximately 40 years of age. CRPS affects women more often than men and people of European ancestry more than people of other ancestral backgrounds. Particular genetic variants may make a person have an increased risk of developing CRPS after sustaining an injury.
How Will Complex Regional Pain Syndrome Affect Me?
The effect that Complex Regional Pain Syndrome has on a person also varies for each person, so it’s difficult to predict how CRPS may impact you personally. Some people with CRPS experience decreased pain after a few weeks or months of physical therapy. Others never stop experiencing pain even after they receive treatment, but their other symptoms may improve over time. Still, others experience a worsening of symptoms and a spreading of the condition from one limb to another.
When individuals adjust their posture to accommodate for the condition, they sometimes experience secondary problems in other body parts. CRPS can also sometimes cause mental health issues.
Is Complex Regional Pain Syndrome a Mental Illness?
No, Complex Regional Pain Syndrome is not a mental illness. It is not psychosomatic or “all in your head.” You are actually experiencing pain and other symptoms, even if they seem disproportional to the underlying injury. However, CRPS can cause or worsen certain mental health conditions, including depression, anxiety, and stress because it can negatively impact the victim’s quality of life. Additionally, these mental health problems can worsen the symptoms of CRPS.
How Can a Lawyer Help Me If I Have Complex Regional Pain Syndrome?
If you have a serious medical condition like Complex Regional Pain Syndrome, the most important thing you can do is focus on your health. A lawyer can handle your legal claim so you can do just that.
Some of the ways a lawyer can help if you have CRPS include:
- Identifying all parties who may be responsible for the harm you’ve suffered
- Explaining your legal rights and options at each phase of your case
- Gathering medical records and other evidence to support your claim
- Handling communication with insurance companies and other relevant parties on your behalf
- Ensuring any settlement you accept properly accounts for your damages
