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Can CRPS Spread?

Can CRPS Spread?

You hurt your right arm and it doesn’t offer as much flexibility as it once did, but it hurts long after the initial injury. Now, you find your other arm hurts because you’re using it more. Your healthcare provider said you may be experiencing complex regional pain syndrome, and the pain likely spread to your other arm.

What Is Complex Regional Pain Syndrome?

Complex regional pain syndrome (CRPS) is a kind of chronic pain that normally affects someone’s arm or a leg. CRPS typically happens following an injury, a medical procedure, a stroke, or cardiac distress. The pain is normally more intense than what an initial injury would appear to cause.

CRPS is rare, affecting only about 200,000 people in the United States annually. Its cause is unknown, but effective treatment happens early and may even result in remission.

Know the Symptoms

The most widespread and prominent symptom of CRPS is pain felt by the individuals. The pain mostly resides deep inside an arm or leg with sensations like burning, stinging, or tearing. People may also have sensory changes, like more sensitivity to painful stimuli, experiencing pain from something that’s normally non-painful, and in some cases, numbness in the affected limb. Other symptoms may include:

  • Changes in skin temperature
  • Changes in skin color and texture
  • Fluctuations in nail and hair growth

Are There Complications?

Like many illnesses, CRPS can result in other potentially serious conditions including:

  • Atrophy, where the bones, muscles and skin may start to deteriorate and weaken if you stop or have problems moving an arm or a leg due to the pain or stiffness.
  • Muscle tightening (contracture). It’s not unusual to experience constriction of your muscles, resulting in a condition where your hand and fingers, or foot and toes, lock into a fixed position.

Is There More Than One Kind Of CRPS?

Yes, there are two:

  • Type 1, also called reflex sympathetic dystrophy. This can happen after an illness or injury where the nerves in the affected limb weren’t damaged. About 90% of those with CRPS are type 1.
  • Type 2, which has symptoms like type 1 but happens following a distinct nerve injury.

CRPS Migration

Can CRPS Spread? As far as a patient with complex regional pain syndrome is concerned, the answer is yes. But from a medical and scientific standpoint, it’s a little fuzzier than a black and white answer.

Instances of CRPS spreading are restricted to a small sample of classic case studies and, more recently, an equally small number of case reports from academic illness-specific pain treatment centers. In this case, the migration or spread pattern is likely representative of dysfunction or chronic changes in the central nervous system near the spinal cord and brain. But similar nervous system variations have been observed in other chronic pain conditions, related to three clinical scenarios: contiguous spread where the pain has edged higher up the same limb, mirror image (pain in the same limb, but on the opposite side), and autonomous spread.

Most of the participants in a recent study of spreading patterns also experienced trauma or had some type of invasive procedure. Some of these cases led researchers to conclude the spreading developed from compensatory misuse of the other initially non-injured limb.

Some clinical studies of CRPS patients have shown changes related to other limbs in this manner. In one case, a patient who experienced a severe crush injury to the hand was observed to have pain and sensitivity to normal harmless light touch (known as allodynia) and other variations of feeling and strength in the other limb. Similar fluctuations in feeling and the occurrence of swelling were seen in the leg on the same side of the body where the injury happened. In this study, symptoms which spread in the same limb or body region are believed to have been linked to myofascial pain syndrome.

The U.S. National Institutes of Health weighed in on the topic and noted that further study is required to answer the question of whether CRPS can spread. The spread of CRPS symptoms often happens without cause and contralateral dispersion is twice as frequent as ipsilateral spread, with diagonal spread a rare occurrence. The researchers concluded by identifying spread patterns as caused by “spinal cord and/or supraspinal mechanisms rather than systemic mechanisms,” but more study is required to clarify the patterns more fully.

Normally, diagnosis relies on a medical examination and may involve certain tests, but the symptoms can be treated with therapy or medicine like ketamine.

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