Complex Regional Pain Syndromes

People who are experiencing unexplained sudden and intense pain in their arms or legs, with associated burning with pins and needles may be suffering from a complex but increasingly common illness. Triggers set off these abnormal sensations, which are then amplified throughout the brain’s processing centers. These episodes can be set off by quite trivial events such as minor jolts, stretches or awkward twisting movements.

We first came across this condition several years ago having reviewed ‘Whiplash Injuries’ by Jack Rook who described the condition and how to diagnose it. As with other syndromes such as myalgic encephalomyelitis (ME) there are some authorities who have suggested it’s not a real illness, but simply a psychological condition. Only with reliable tests has ME been recognized as a genuine illness, and a treatment strategy to help sufferers. It’s similar with complex regional pain syndrome (CRPS) or its other title of reflex sympathetic dystrophy syndrome (RSDS).

Functional MRI which shows the brain’s anatomy, but also a visual map of what happens when it’s working in the world. The blood flow patterns seen in the living brain show that certain regions of the brain become active when stimulated. For example when we hear someones voice or listen to music, the temporal lobe at the side of the brain becomes active and then begins to send signals to some of the central structures located deep within the brain, such as the limbic system and the thalamus.

The current research in this complex illness is now assisting in understanding other severe or chronic pain pattern illnesses such as migraine, facial pain (Bell’s palsy), shingles (post herpetic neuralgia) and chronic post operative pain syndromes.

Chronic pain conditions affect many people in the UK. Many of the clues on what CRPS is, how it presents and how best to treat those affected, will help with other painful conditions. Some of the clinical approaches used to treat chronic pain recognize that there are general biochemical changes and irregular levels of neurotransmitters seen in many patients. These include poor breathing function, irregular sleep patterns, and poor nutritional factors. There is invariably a history of an inability to exercise regularly which brings with it poor posture and muscle tone.

Osteopathic treatment which incorporates an integrated physical therapy including acupuncture and nutritional approach can be helpful in managing CRPS, and has none of the side-effects seen in patients who have been prescribed long term anti-depressants and anti-inflammatory drugs from their GP.