HOW CAN YOU ‘GET’ COMPLEX REGIONAL PAIN SYNDROME (CRPS)?

WHAT CAUSES CRPS?

According to specialists and doctors who deal with CRPS patients, the actual cause or how you can ‘get’ Complex Regional Pain Syndrome (CRPS) is as of yet unknown. However research does say that CRPS most likely does not have a single cause but multiple causes. (Web MD)

In the 2011 research by Goebel, A. it is stated that significant scientific and clinical advances over the past 10 years hold promise both for an improved understanding of the causes of CRPS. Therefore research is still ongoing into what causes Complex Regional Pain Syndrome. CRPS is a chronic neuropathic pain condition that may affect different systems within the body including the sympathetic nervous system. This is why no one person diagnosed with CRPS will have the exact same symptoms as someone else.

According to Janig & Baron (2003) they have stated that:

“On the basis of clinical observation and research in human beings and animals, we hypothesise that CRPS is a systemic disease involving the CNS and peripheral nervous system.”

The NINDS website on CRPS (2015) gives a description of how you can get CRPS or what causes CRPS as:

“CRPS represents an abnormal response that magnifies the effects of the injury. In this respect it is like an allergy. Some people respond excessively to a trigger that causes no problem for other people.”

The syndrome usually will affect 1 or more regions of the body for example arms, hands and legs; however there are people who have CRPS in the whole of their body or in their internal organs or facial area. The 2 main types of CRPS being CRPS Type I (this is the new name for what used to be known as Reflex Sympathetic Dystrophy Syndrome) this happens where there is no certain damage to a nerve. CRPS Type II (which used to be called Causalgia) happens when there is a direct injury to a nerve. However when it is developed, the pain that is felt is totally out of proportion to the actual injury such as following a fracture or broken bone. There are occasions where the syndrome has onset but there has been no actual cause or reason for it. There is a 3rd type which is CRPS-NOS or CRPS Not Otherwise Specified (RCP Guidelines for CRPS) In a research study by Lee, W.H. (2015) he stated that there were a number of possible causes of complex regional pain syndrome including:

“…. tissue damage, nerve damage, casting, traumas, fractures, burns, frostbites, strokes, and other non-identifiable causes”

It has been noted among health professionals that Complex Regional Pain Syndrome (CRPS) may develop after any of the following incidents:

Minor injury
Soft tissue injury
Nerve damage
Laceration
Deep wound
Spinal-cord injury
Surgery
Fracture / broken bone
Castings
Strains
Sprains
Heart attack
Stroke
Neck problems
Infection
Cancer
Pressure on a nerve
Burns
Frostbite

The list above is by no means definitive and there are cases where the sufferer doesn’t even know how or when an incident occurred for the Complex Regional Pain Syndrome to set in. According to the Mayo Clinic website (2014) they say that a possible cause for CRPS:

“.. may be due to a dysfunctional interaction between your central and peripheral nervous systems and inappropriate inflammatory responses.”

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In a study from 2014 by Moseley, G.L. et al. it was mooted that if someone who had fractured their wrist had a pain intensity of 5/10 or more on average for 2 days then this should be a red flag for Complex Regional Pain Syndrome (CRPS).

MEDICAL INFORMATION on the CAUSES of CRPS

Researchers have found in their studies of the causes of CRPS that they believe that CRPS begins because of an abnormal response to an injury that has resulted in 4 main systems in the body to malfunction. These 4 main systems include:

PERIPHERAL NERVOUS SYSTEM – The nerves that are around the outside of the central nervous system

CENTRAL NERVOUS SYSTEM – Brain and spinal cord

BLOOD VESSELS – Arteries and veins that send the blood around the body

IMMUNE SYSTEM – This is the body’s natural defence against infection and illness

(NHS Choices website ‘Complex Regional Pain Syndrome’) Goebel, A. (2011) explains in his research study that:

“The condition’s distinct combination of abnormalities includes limb-confined inflammation and tissue hypoxia, sympathetic dysregulation, small fibre damage, serum autoantibodies, central sensitization and cortical reorganization.”

Another theory that the Web MD article (2015) suggests is that:

“… pain receptors in the affected part of the body become responsive to catecholamines, a group of nervous system messengers.”

Obviously more research has to be done to find out what causes Complex Regional Pain Syndrome. To help improve the amount of research that is done for CRPS and all parts of CRPS like how you get CRPS, treatments, symptoms etc.. contact your regional MP or Senator for those outside the UK. Or contact the various MPs concerned with health and disability and tell them about yourself and talk about the lack of research available for CRPS. For those in the UK here are the links to the MPs: Your regional MP Living with Complex Regional Pain Syndrome can be complex and after being diagnosed with CRPS you often don’t know why you have got CRPS or what caused the signs and symptoms to start. This is why we have information on all areas of life with CRPS including how you can ‘get’ CRPS. Understanding how you can get CRPS or what are the main known causes of CRPS is an integral part of learning about Complex Regional Pain Syndrome (CRPS).

CITED RESEARCH / WEBSITES / ARTICLES

Goebel, A. (2011) ‘Complex Regional Pain Syndrome in adults,’Rheumatology. 2011. Vol 50 (10). pp 1739-1750. Available from: <http://rheumatology.oxfordjournals.org/content/50/10/1739.short> doi: 10.1093/rheumatology/ker202 1st published online June 28, 2011
Jänig, Baron, Wilfrid et al (2003) ‘Complex regional pain syndrome: mystery explained?’ The Lancet Neurology. Volume 2, Issue 11, pp. 687 – 697. Available from: <http://www.thelancet.com/pdfs/journals/laneur/PIIS1474-4422(03)00557-X.pdf>
Mayo Clinic (2014) ‘Complex Regional Pain Syndrome: Causes,‘ Mayo Clinic website. 2014, April 12. Available from: < http://www.mayoclinic.org/diseases-conditions/complex-regional-pain-syndrome/basics/causes/con-20022844>
Moseley, G.L. et al. (2014) ‘Intense pain soon after wrist fracture strongly predicts who will develop complex regional pain syndrome: prospective cohort study,’Journal of Pain. 2014, January. Vol 15(1) pp 16-23. Available from: <http://www.ncbi.nlm.nih.gov/pubmed/24268113>
NHS Choices (2014) ‘Complex Regional Pain Syndrome – Causes,’NHS Choices website. 2014, May 9. Available from: < http://www.nhs.uk/Conditions/Complex-Regional-Pain-Syndrome/Pages/Causes.aspx>
NINDS NIH (2015) ‘Complex Regional Pain Syndrome Fact Sheet,’NINDS website. 2015, February. Available from: <http://www.ninds.nih.gov/disorders/reflex_sympathetic_dystrophy/detail_reflex_sympathetic_dystrophy.htm>
Ratini, M. (2015) ‘Complex Regional Pain Syndrome,’Web MD website. 2015, April 15. Available from: <http://www.webmd.com/pain-management/guide/complex-regional-pain-syndrome#1>
RCP Guidelines for CRPS (2012) ‘CRPS in adults: UK Guidelines for Diagnosis, Referral and Management in Primary and Secondary Care,’RCP London website. Available from: <https://www.rcplondon.ac.uk/guidelines-policy/pain-complex-regional-pain-syndrome>