Complex regional pain syndrome (CRPS) is a neurological condition that causes pain and other symptoms in your extremities — most commonly your hand. There are several treatment options for CRPS. The sooner you receive a diagnosis and treatment, the more likely your symptoms will improve.
Complex regional pain syndrome (CRPS) is a neurological condition that causes pain and other symptoms in a certain part of your body — usually in your arm, leg, hand or foot.
Complex regional pain syndrome (CRPS) is a condition that causes pain, changes in skin color and other symptoms in a certain part of your body — usually in your extremities. Your extremities include your arm, leg, hand or foot.
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Experts believe that CRPS occurs as a result of dysfunction in your central or peripheral nervous systems. Your central nervous system consists of your brain and spinal cord. Your peripheral nervous system relays information from your brain and spinal cord to your organs, arms, legs, fingers and toes. The abnormal functioning results in an overreaction to pain signals that your nervous system can’t shut off.
CRPS more commonly affects adults than children. The peak onset is around 40 years of age. CRPS affects people assigned female at birth more often than people assigned male at birth.
Symptoms of CRPS typically start within four to six weeks after an injury, fracture or surgery, but they can develop without a known cause.
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The most common and prominent symptom of CRPS is pain. The pain is constant or intermittent and is a burning, stinging or tearing sensation. It’s often deep inside your affected limb.
Since the symptoms of CRPS usually improve over time, it’s easiest for healthcare providers to diagnose it in the early stages. It’s important to see a provider soon after you experience symptoms of CRPS.
Researchers aren’t sure why some people develop CRPS while others with similar injuries don’t. They think it’s due to an inflammatory or immune reaction in both your peripheral and central nervous systems.
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In more than 90% of cases, CRPS results from nerve trauma or injury to the affected limb that damages the thinnest sensory and autonomic nerve fibers. These small fibers transmit pain, itch and temperature sensations. They also control the small blood vessels and the overall health of surrounding cells.
The most common injury associated with developing CRPS is a bone fracture, especially a wrist fracture. A displaced or splintered bone or pressure from a tight cast can damage nerves.
There’s no specific test to diagnose CRPS. Healthcare providers mainly diagnose it through a careful medical history, physical examination and review of your symptoms. Your provider will ask you if you’ve had a recent injury or surgery.
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They may order imaging tests, such as an ultrasound or magnetic resonance imaging (MRI), to look for underlying nerve damage. But it’s not always possible to find the nerve damage.
Your provider may also order other tests to rule out conditions that cause similar symptoms. For example, electroography (EMG) may reveal other causes of neuropathy, which may result in some similar pain scenarios.
The goal of treatment is to decrease your pain and other symptoms, restore function to the affected limb and maintain the quality of your life.
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It’s important to start treatment early in the course of CRPS. This is because CRPS can cause the affected limb to stiffen over time. In addition, the pain usually worsens without treatment and movement becomes more and more difficult.
It’s best to see healthcare providers who have experience in treating CRPS, if possible. Treatment requires a combination of carefully managed approaches, including:
For young children with CRPS, psychosocial and rehabilitation therapies are the mainstay treatment. Healthcare providers typically only suggest pain-reducing medical procedures for older adolescents who have symptoms that aren’t responding to other therapies.
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A physical therapist can help improve blood flow to your affected limb as well as increase your flexibility, strength, muscle tone and function with certain exercises. An occupational therapist can teach you new ways to accomplish everyday tasks.
Removing certain barriers that can prevent your nerves from healing can help increase the chance of recovery and the speed of recovery, including:
Having CRPS is associated with worsening anxiety, depression and stress, which can increase pain. Psychotherapy can help. Psychotherapy, also called talk therapy, is a term for a variety of treatment techniques that aim to help a person identify and change unhealthy emotions, thoughts and behaviors.
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If possible, it’s best to see a pain management clinical psychologist with training in treating CRPS. During psychotherapy, you talk to the psychologist to learn ways to better cope with factors that contribute to your pain and other symptoms.
No medications are specifically approved for CRPS in the U.S. However, your healthcare provider may recommend certain medications to manage your symptoms.
If your CRPS hasn’t responded well to the therapies mentioned above or you have severe pain or ongoing CRPS, your provider may recommend the following more invasive treatments:
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Since researchers don’t know the exact cause of CRPS, there’s no conclusive way to prevent it. Some studies have revealed that taking vitamin C before a future surgery might prevent CRPS.
Each person’s experience with CRPS is different. CRPS usually improves over time and eventually goes away (goes into remission) in most people.
Severe or prolonged cases, which are rare, can greatly affect your life. In some people, CRPS gets worse and even spreads to other areas of their body. Experiencing increased psychological distress during the injury that led to CRPS may affect its severity and prognosis.
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The most important goals are to relieve pain and restore movement and strength in the affected limb. By achieving pain relief, you increase the odds of improving its function and your quality of life. Carefully selected treatment plans allow some people with CRPS to successfully manage their pain and lead active lives.
Because of the complexity of this condition and the fact that it’s often misdiagnosed, seek out a pain management specialist or a specialty pain center with knowledge of CRPS if:
In the United States, the Social Security Administration recognizes CRPS as a potential cause of disability depending on its severity and impact on your life. Consult government officials for more information on the Social Security Administration’s eligibility requirements.
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No, CRPS isn’t a mental health condition. It’s a neurological condition. CRPS can, however, cause or worsen anxiety, depression and stress. It can sometimes lead to post-traumatic stress disorder (PTSD).
Complex regional pain syndrome (CRPS) can greatly affect your quality of life. The good news is that there are many treatment options and many combinations of options that you can try. The earlier you receive a CRPS diagnosis and start treatment, the better the chance that your symptoms will respond to treatment. If you think you may have CRPS, talk to your healthcare provider. They’re available to help you.
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To understand the magnitude of input of plastics to the natural environment and the world’s oceans, we must understand various elements of the plastic production, distribution and waste management chain. This is crucial, not only in understanding the scale of the problem but in implementing the most effective interventions for reduction.
In 1950 the world produced only 2 million tonnes per year. Since then, annual production has increased nearly 230-fold, reaching 460 million tonnes in 2019.
The short downturn in annual production in 2009 and 2010 was predominantly the result of the 2008 global financial crisis — a similar dent is seen across several metrics of resource production and consumption, including energy.
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The chart shows that by 2019, the world had produced 9.5 billion tonnes of plastic — more than one tonne of plastic for every person alive today.
How has global plastic waste disposal method changed over time? In the chart we see the share of global plastic waste that is discarded, recycled or incinerated from 1980 through to 2015.
Prior to 1980, recycling and incineration of plastic was negligible; 100 percent was therefore discarded. From 1980 for incineration, and 1990 for recycling, rates increased on average by about 0.7 percent per year.2
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If we extrapolate historical trends through to 2050— as can be seen in thechart here— by 2050, incineration rates would increase to 50 percent; recycling to 44 percent; and discarded waste would fall to 6 percent. However, note that this is based on the simplistic extrapolation of historic trends and does not represent concrete projections.
To which industries and product uses is primary plastic production allocated? In the chart we see plastic production allocation by sector for 2015.
Building and construction was the second largest sector utilizing 19 percent of the total. Primary plastic production does not directly reflect plastic waste generation (as shown in the next section), since this is also influenced by the polymer type and lifetime of the end product.
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This chart shows the
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