CRPS: Type 1 Vs. Type 2

If you broke an arm or leg, it’s normal to experience occasional discomfort even after the injury heals. But if the pain is severe, lasts more than six months, and you begin noticing physical changes in the injured limb, you may be experiencing what’s known as complex regional pain syndrome.

What Is CRPS?

“Complex regional pain syndrome (CRPS) is a form of chronic pain that usually affects an arm or a leg. CRPS typically develops after an injury, surgery, a stroke, or a heart attack. The pain is out of proportion to the severity of the initial injury.” According to the Reflex Sympathetic Dystrophy Syndrome Association, complex regional pain syndrome has been diagnosed in 700,000 people as of 2019. Fortunately, many of its symptoms can be treated.

What Is Type 1?

Reflex sympathetic dystrophy (RSD) syndrome is older terminology employed to explain one kind of complex regional pain syndrome. Both are chronic conditions distinguished by severe burning pain, primarily impacting one of your extremities (such as your arms, feet, hands, or legs). You may also notice other pathological shifts in bone and skin, extreme sweating, swollen tissue, and intense sensitivity to touch, also known as allodynia. It’s sometimes triggered by tissue injury without underlying nerve injury.

What Is Type 2?

CRPS Type-2 is also known as causalgia, an uncommon pain disorder related to limited peripheral nerve damage. Our peripheral nervous system includes nerves that stretch from the central nervous system in the brain and our spinal cord to assist limbs and organs in how they function. It’s not unusual to experience burning pain in the hands and feet within 24 hours of an injury, “increased or decreased blood flood,” dry skin, and other symptoms.

How To Prevent CRPS?

Besides trying ketamine therapy to stop the symptoms of CRPS, there may be other preventative measures worth considering:

• Taking vitamin C after a wrist fracture may lower the risk of people who don’t take vitamin C.
• Staying physically active following a stroke. Some research indicates that people who get out of their bed and walk about quickly after a stroke (a strategy called “early mobilization”) reduce their risk of getting complex regional pain syndrome.

CRPS: Type 1 Vs. Type 2

Complex regional pain syndrome Type 1 and Type 2 are related to one another and have some differences to be aware of. Type 1 may be caused by what’s referred to as a “noxious event” like immobilization, sprain, a stubbed toe, or getting a slight poke to the skin with a needle; nerves most impacted – spontaneous. Type 2 is typically caused by a physical trigger or direct injury to a peripheral nerve (through a cut, surgery, or accident); nerves most impacted – median and sciatic.

Typical symptoms may include:

• “Unprovoked or spontaneous pain that can be constant or fluctuate with activity. Some say it feels like a ‘burning’ or ‘pins and needles sensation, or as if the affected limb was being squeezed.”
• You may experience excess or sustained pain following the use of the affected area or if it’s in contact with something.
• You may notice changes in skin temperature, general skin color, or swollen the affected limb.
• Visible fluctuations in skin texture could indicate the condition. Over time, there may be an insufficient distribution of oxygen and nutrients that can trigger texture changes in the skin of the affected limb.
• You may notice unusual sweating or hair and nail growth on the affected area or limb.
• In both Type 1 and Type 2, complex regional pain syndrome may be characterized by pronounced stiffness in affected joints.
• Wasting away or excess bone growth.
• With either Type 1 or Type 2, there may be impaired muscle strength and movement.

Diagnosis & Treatment

There aren’t any specific tests that can confirm CRPS and identify injured nerves. Diagnosis may include:

• A thorough examination by a doctor like a neurologist, orthopedist, or plastic surgeon with expertise in normal patterns of sensory nerve anatomy.
• Nerve conduction studies.
• Imaging nerves by ultrasound or magnetic resonance imaging.
• Triple-phase bone scans may show CRPS-associated excess bone resorption, assisting with diagnosis and localization.

Once there’s a CRPS diagnosis, your doctor may recommend one or several kinds of treatment, depending on your health and other factors, including rehabilitation and physical therapy, psychotherapy, medicine, and ketamine.

Final Thoughts

If you suffer from complex regional pain syndrome or other chronic pain conditions, seek professional medical care before the symptoms and discomfort ruin your quality of life. With time and care, most symptoms can be treated. For more information on CRPS, ask your doctor about the best treatment available.