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Neurology

Complex Regional Pain Syndrome

Complex regional pain syndrome, is also known as Sudeck's atrophy, reflex sympathetic dystrophy, shoulder-hand syndrome, or causalgia. It is rare and usually developed after injury, surgery, heart attack, or stroke.

Complex Regional Pain Syndrome
Complex regional pain syndrome is also known as Sudeck's atrophy, reflex sympathetic dystrophy, shoulder-hand syndrome, or causalgia. This syndrome causes intense pain to the affected person; it can damage the arms, hands, or legs.

Complex regional pain syndrome is rare, and is usually developed after injury, surgery, heart attack or stroke. The pain is different concerning the severity of the first damage.

When treatment started on time, it is more efficient, generating improvement for the patient.

Causes of Complex Regional Pain Syndrome

It is difficult to know the cause of complex regional pain syndrome. In most cases, doctors cannot determine a specific cause. 
Some of the causes in which it can occur are derived from trauma or injury. 

There are two types of complex regional pain syndrome, with similar signs and symptoms, but with different causes: 
  • Reflex sympathetic dystrophy or Type 1 is the most common, occurs after an illness or injury that did not directly affect the nerves of the affected limb. 
  • Causalgia or Type 2, the symptoms are similar to those of type 1; however, this happens after a different nerve injury. 

Not everyone with an injury develops complex regional pain syndrome.

Symptoms of Complex Regional Pain Syndrome

We group the most frequent symptoms that can occur: 

  • Changes in skin color

  • Changes in skin texture 

  • Extreme changes in skin temperature 

  • Variation in hair and nail development 

  • Burning pain in the arm, leg, hand or foot 

  • Increased skin sensitivity 

  • Inflammation or stiffness of the joints 

  • Problems to move the affected body part 

Complex regional pain syndrome can occasionally spread from its origin to other parts of the body. Symptoms can change over time and vary depending on the person. In some cases, the signs and symptoms may go away on their own.

Diagnosis of complex regional pain syndrome


The Orthopedist or Neurologist will perform a physical exam and ask questions related to your symptoms, lifestyle, and medical history.

Following are some of the most common tests that could be carried out: 

Treatment of complex regional pain syndrome 

The treatment to be used will depend on the cause and severity of the condition. 

Treatments for complex regional pain syndrome are: 

  • Medicines 

    • Analgesics 

    • Antidepressants and anticonvulsants 

    • Corticosteroids (help to lower inflammation and improve movement of the affected area) 

    • Medicines against bone loss 

    • Medications for sympathetic nerve block 

    • Intravenous ketamine 

  • Therapies 

    • Acupuncture 

    • Biofeedback (to become more aware of your body so you can relax and relieve pain). 

    • Intrathecal drug pumps 

    • Spinal cord stimulation 

    • Transcutaneous electrical nerve stimulation 

    • Physical therapy or occupational therapy

    • Heat therapy 

    • Mirror therapy

Exposing yourself to cold or stress can cause complex regional pain syndrome to recur. It can be treated with small doses of medicine.

Living with Complex Regional Pain Syndrome 

Following the treatment provided by your Orthopedist or Neurologist and leading a healthy lifestyle could improve the quality of life.

We group the following recommendations: 

  • Do activities that you can do, and you enjoy 

  • Maintain a routine of daily activities 

  • Keep in touch with your family and friends

  • Contact a psychologist or therapist  to help you deal with your emotions

When to go to a doctor?

Make your appointment with the doctor (Orthopedist, Traumatologist or Neurologist) in case of presenting any of the mentioned symptoms or in case of detecting another abnormal symptom.
The doctor will be in charge of making a diagnosis to identify the possible cause of the symptoms and identify the severity of the disease.
It is necessary to immediately treat complex regional pain syndrome to avoid aggravating the situation.


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