Complex Regional Pain Syndrome Type 1 (CRPS Type 1)

Complex Regional Pain Syndrome Type 1 (CRPS Type 1)

Complex Regional Pain Syndrome (CRPS) is considered to be the most painful disorder known to humanity, rating even higher on the McGill Pain Index than amputation and child labor. The pain that patients experience with CRPS is prolonged or even constant, so it is particularly difficult for patients to find relief. Usually, it develops as a result of a malfunction of the central nervous system or after a surgery or injury. Sometimes the Complex Regional Pain Syndrome can spread and affect the whole limb even though it was only a finger or a toe that was harmed before. The area where the disease has developed can be extremely sensitive, and normal contact with its skin turns out to be excruciatingly painful to a patient (such a condition is called allodynia).

The Causes of CRPS

The exact reasons for CRPS development are still not known because in some cases of the similar trauma, this disease occurs, and in others, it does not. In the vast majority of cases, this disorder is a consequence of a confirmed injury or trauma. It can be a strain, sprain, fracture, surgery, having your limb in a cast, or a tissue injury (bruises, burns, cuts). Interestingly, even a minor procedure such as a needlestick can contribute to the development of Complex Regional Pain Syndrome. This condition stems from an abnormal response from the central nervous system that increases the injury’s impact. The same as with allergies, some people’s reaction to such a trigger is extreme while in others, it causes no side effects.

In patients with CRPS, some peripheral nerve abnormalities were found. Most commonly, they are associated with tiny, unmyelinated, or slightly myelinated nerve fibers that transfer pain notifications to blood vessels. An injury of such a fiber may stimulate various symptoms of Complex Regional Pain Syndrome because, in this way, communication with blood vessels is damaged. Molecules that come from the ends of those extremely active fibers are said to be one of the reasons for inflammation or blood vessel malfunctions. Furthermore, such abnormalities generate unusual neurological reactions in the brain and spinal cord.
It is worth knowing that CRPS has an impact on the immune system as well. Patients with this disease have high amounts of cytokines (inflammatory substances) in their bodies. As a result, they often experience swelling, warmth, and redness of the infected area. People with other inflammatory and autoimmune diseases (like asthma) tend to be more prone to this condition, so they should be particularly cautious and carefully observe the symptoms.

What is more, some data is suggesting that genetics can also be the reason for CRPS. However, few family clusters of this disease have been registered. Nevertheless, in the reported cases, it was observed that the disease takes a harsher form with more significant dystonia. Moreover, in this form of Complex Regional Pain Syndrome, usually more than just a single limb is affected.

Also, sometimes it happens that CRPS develops with no visible injury in the past. It is because it can also occur as a result of internal damage caused by a blood vessel issue, an entrapment of the nerves, or an infection. In this case, a physician needs to perform a precise examination so that the cause could be properly discovered.
Moreover, it often happens that CRPS stems from a combination of reasons. When it happens, all the contributing causes need to be properly treated.

In accordance with the causes, we can distinguish 2 types of Complex Regional Pain Syndrome:

  • CRPS type 1 (also known as Reflex Sympathetic Dystrophy), developing after an injury or illness that did not directly harm a nerve in the infected area,
  • CRPS type 2, being an effect of an apparent nerve injury.

The Stages of Complex Regional Pain Syndrome Type 1

CRPS Type 1 has three main stages:

Stage 1: Severe

The first stage of Reflex Sympathetic Dystrophy can last for as long as three months. In this phase, patients mostly suffer from high sensitivity to touch and burning pain. With time, the pain evolves and becomes longer-lasting or even constant which is not normal for the type of injury that happened before. Apart from that, joints are usually getting stiff and swelling, and the affected limb becomes warmer and more intensely red. Moreover, a patient may sweat more excessively, and their hair and nail may grow extraordinarily fast.

Stage 2: Dystrophic

The time of the second phase can be various – from three months up to a year. During that period, the skin temperature gets noticeably lower, while swelling is more constant with skin wrinkles being not visible anymore. Stiffness intensifies, pain is spreading, and the infected limb starts to be incredibly sensitive to touch.

Stage 3: Atrophic

The final stage typically starts after a year. Then, the affected limb is getting stiffer, and it is harder and harder to move it. Furthermore, the skin on it starts to be dry, pale, shiny, and more firmly stretched. Although the pain may be a bit less severe in this phase, it is likely to spread to other areas of the patient’s body.

How is the Complex Regional Pain Syndrome Type 1 Diagnosed

Up to this point, medicine has not discovered any specific test to identify Reflex Sympathetic Dystrophy (the same goes for CRPS type 2). To diagnose it properly, the doctors take into consideration the signs, symptoms, and medical history of a patient. It should be kept in mind that there are also other diseases with symptoms similar to CRPS, so the examination must be comprehensive. The condition of most patients slightly improves as time goes by, so in the later stages, it can be harder to identify the Complex Regional Pain Syndrome.
To reduce the possibility of confusing CRPS with a different disease, several tests can be conducted, for example, to rule out Lyme disease, a clotted vein, arthritis, small fiber polyneuropathies, generalized muscle illnesses, etc. The most distinctive aspect of Complex Regional Pain Syndromes (both types 1 and 2) is that the affected area was injured in the past. People with such medical history need to be carefully examined so that such a disease would not be overlooked.

In order to confirm an assumption of Reflex Sympathetic Dystrophy, triple-phase bone scans and magnetic resonance can be performed. CRPS tends to involve excess bone resorption (cells breaking down the bones which results in calcium reaching the blood), but such a condition can occur in other diseases as well.

The Most Common Pain Relief Solutions for CRPS Type 1

Nowadays, it is most common to use pain relief treatments to help patients with Complex Regional Pain Syndrome Type 1. These are, for example:

Ketamine

The main task of a dissociative anesthetic called ketamine is to set your brain free from the pain. For some patients, it works on a short-term basis, and the effects are not permanent, so they need to take infusions repeatedly. As a result, even though a person feels better, CRPS is still developing because it is just a painkiller, not a cure. Finally, the disease may be at such a severe stage that ketamine can no longer ease the pain. Also, this substance has many significant side-effects.

Sympathetic Nerve Blocks

For a sympathetic nerve block, anesthetic medication needs to be injected into a nerve around the spine so that the pain could be numbed. In most cases, it has to be done multiple times to achieve the desired effect, and it results in scarring the tissue. If you are already suffering from CRPS, you certainly do not want to add any other conditions to deal with in the future.

Opioids

It often happens that to survive the day, a CRPS patient uses opioids, but you need to bear in mind that the dangers and effects of narcotics may not be worth it. Actually, any prescription drug you use may have a deteriorating impact on your body – increasing the number of chemicals that are affecting your organism can have terrible consequences.

Calmare

Calmare treatment is based on applying a low-amperage electric signal that imitates the one that a human brain typically uses. In this way, the brain is tricked in a way because the code it gets indicates that there is no pain. It has to be admitted that calmare therapy is not as invasive as taking chemicals; nevertheless, it does not cure CRPS and allows it to develop further, just easing the pain for a certain period of time. Moreover, there have been some cases of patients saying that it did not stop their pain, but the other way round – made it spread to other parts of the body, so this kind of physical therapy is risky.

How Does Spero Clinic Treat Complex Regional Pain Syndrome (CRPS) Type 1

Many patients who reach Sero Clinic tried everything that was available for them so far. They are often woeful and think that there is little hope for them to recover from CRPS. We never make any promises because everybody is different and may have its own reaction to the therapy, but we are here to bring back hope. We do our utmost to help every CRPS patient, no matter what serious condition they are in, and in most cases, our treatment is successful.
In order to cure people suffering from CRPS Type 1, we take a lot of different steps, such as the following:

  • Healing the pain triggers naturally through balancing the central nervous system and the brain,
  • Enhancing the mental functions and restoring the energy thanks to the balance of the nervous system,
  • Reducing inflammation so that any form of pain could be eased (no matter if it is the feeling of burning, stabbing, or other), and also to make the tone of the vagus nerve restored,
  • Improving the immune system with a magnetic resonance treatment so as to minimize stress and anxiety,
  • Individual retraining the body so that it could learn the pain function again and gave up the wrong patterns,
  • Neuromuscular re-education of the body, so that it could acquire the proper coordination and balance back and forget the patterns of permanent trauma and illness,
  • Raising the range of motion by preventing atrophy, enhancing blood circulation and easing the muscle spasm,
  • Heart rate therapy making your heart reach healing sound frequencies,
  • Unblocking the flow of electric current by decreasing the scar tissue,
  • Ionic treatment that applies charged particles which remove toxins from your body, balance your PH, minimizes swelling, improve the immune system, and eliminate harmful fungus, microorganisms, and bacteria,
  • Oxygen therapy provides the body with healing nutrients through the pathways that were previously clogged by CRPS.

Why Are We Different

We take the holistic approach while dealing with CRPS patients. We do not agree with the mechanical approach that some doctors have because the human body is not like an engine, and you cannot treat just one part of it separately if they are all tightly connected.
Also, we believe that a strong bond between the doctor and the patient, and the support and understanding that comes from it, can affect the success of CRPS therapy to a large extent. We approach every patient individually, and we are with them in their struggles and their accomplishments. Interestingly, some of our staff members used to be CRPS patients as well, so they perfectly understand what you are going through. In our practice, you will experience a friendly atmosphere and even socialize with other patients if you want. Such an attitude combined with modern equipment and innovative treatments creates a huge chance for you to recover from CRPS sooner or later. It does not matter if this disease comes from an apparent nerve injury (type 2) or damage that did not harm the nerve directly (type 1) – we are here to help you. Contact us now!