MedClinic > Blog > Algology > Complex pain syndrome


Complex regional pain syndrome is an extremely rare form of pathological pain of the upper or lower extremities. It occurs after severe injuries of the limbs, due to surgery or undergoing serious diseases: heart attack, stroke.

Factors of development

Depending on the causes leading to the appearance of pain, it can be divided into two groups:

  • symptomatic dystrophy;

Any pathological process, be it a fracture, rupture of a blood vessel, stroke or heart attack, can cause damage to nerve fibres, with the further development of a regional pain syndrome. Constant stressful situations are a factor that provokes the development of pathology.

It is still not known for certain what exactly causes the development of pain of the upper and lower extremities, but there is a close relationship between the development of this disease and disruption of interaction of two body systems – peripheral and central.

Signs and manifestations

A complex regional pain syndrome has nonspecific features that are similar to a number of other pathological processes:

  • constant burning sensation in legs or arms;
  • throbbing pain;
  • increased sensitivity of the skin of extremities to low temperatures;
  • change in the temperature regime of the skin – it may suddenly become covered with drops of sweat, or become very cold;
  • discolouration of the skin, it becomes glossy;
  • swelling of the soft tissues of the upper or lower extremities;
  • difficulty moving;
  • convulsive muscle contractions;
  • muscle atrophy.

How to determine it?

The main diagnostic methods are examining the patient and studying his full history. There are no medical examination methods for diagnosing CRPS, so it is extremely important for the patient to accurately describe their symptoms.

An additional measure that helps determine the degree of damage to the roots of nerve endings is scintigraphy, to study of the nervous system there is thermography.

To determine the degree of damage to the upper or lower extremities, an X-ray and magnetic resonance imaging are performed.

How to treat it?

It is almost impossible to completely cure a regional pain syndrome, but with timely medical attention and proper treatment, it is possible to significantly alleviate the patient’s condition, stop the symptomatic picture and maximize remission. The treatment methods are selected by the doctor individually for each patient, it all depends on the stage of development of the pathology, the severity of symptoms, the presence of complications and concomitant diseases.

The first measure in the treatment of the disease is the conduction of pharmacotherapy. Painkillers are prescribed, aimed at stopping the pain syndrome and normalising the motor function of the limb. In the absence of positive dynamics from taking painkillers with a general spectrum of action, which is available without a prescription (over-the-counter), the doctor prescribes more severe drugs from the opioid group to stop the pain.

The administration of vasoconstrictive and antidepressant medications is mandatory. In some cases, antidepressants help to cope with the manifestations of pain. To reduce inflammation and relieve swelling in the soft tissues, corticosteroids are prescribed, in particular, prednisolone, which helps restore limb mobility.

In the absence of positive dynamics from taking painkillers, heavy drugs, a blockade is carried out. This procedure involves the introduction of strong painkillers directly into the area of ​​the nerve.