Understanding CRPS (Complex Regional Pain Syndrome): Causes & Treatment

Complex Regional Pain Syndrome (CRPS), formerly called Reflex Sympathetic Dystrophy (RSD), is a chronic pain condition that often emerges after an injury, surgical procedure, or other physical trauma. While the precise cause remains under investigation, CRPS involves a disruption in how the nervous system interprets and processes pain signals, resulting in severe and sometimes prolonged discomfort. At Greater Austin Pain Center, we aim to restore function and ease pain through expert diagnosis, individualized therapies, and a compassionate care philosophy. Continue reading to learn more. 

What Is CRPS and Who Is Affected?

CRPS typically begins in an arm, hand, leg, or foot following a seemingly routine event such as a fracture, sprain, or minor surgery. In many cases, the level of pain is disproportionate to the original injury, and it can persist long after typical healing should have occurred. The condition is divided into two primary types:

• CRPS I is diagnosed when no specific nerve injury can be confirmed, yet symptoms still appear.
• CRPS II involves a clear, identifiable nerve injury that leads to ongoing pain and related symptoms.

Although anyone can develop CRPS, it is more frequently seen in individuals with a prior history of nerve damage, autoimmune disorders, or other chronic pain conditions. Hormonal differences may also play a role, as CRPS appears more commonly in women than in men.

Common Signs & Symptoms of CRPS

Many people with CRPS experience significant pain that far exceeds what one might expect from the initial injury. This discomfort often manifests alongside visible changes in the skin—such as swelling, discoloration, or temperature fluctuation—and may be accompanied by muscle weakness or tremors in the affected limb. A hallmark of CRPS is allodynia, in which even the lightest touch or slight temperature difference can spark intense pain. Other potential indicators include heightened sensitivity to stimuli, unusual sweating in the affected area, stiff or swollen joints, and changes in hair and nail growth.

In addition to these core symptoms, CRPS tends to evolve over time. Many individuals go through distinct stages—acute, dystrophic, and atrophic—each with its own set of characteristics. If the condition progresses without appropriate intervention, symptoms can intensify and lead to more severe functional limitations, such as persistent swelling, pronounced skin changes, and joint stiffness. Because these indicators overlap with other conditions, an accurate diagnosis is critical for effective treatment. Early detection and a clear understanding of CRPS’s stage-based progression can substantially improve long-term outcomes.

Breaking Down the Stages of CRPS

Early (Acute) Stage

During the initial stage, symptoms may appear suddenly and are often marked by redness, warmth, and swelling in the affected limb. Skin can also become highly sensitive, causing even light touches or mild temperature changes to trigger intense pain—a phenomenon known as allodynia. In some cases, the area may exhibit rapid changes in color or develop a glossy sheen. Early intervention is critical at this point because targeted therapies—ranging from anti-inflammatory medications to gentle exercises—can help contain the body’s overactive pain response before it becomes entrenched.

Intermediate (Dystrophic) Stage

If left unchecked, CRPS can progress to the dystrophic stage, where the pain remains persistent and may even intensify. Individuals often notice muscle wasting (atrophy) due to reduced use of the affected limb, along with increased stiffness and more pronounced swelling. Changes in hair growth, nail texture, or skin temperature become more apparent as the condition affects both nerves and surrounding tissues. At this stage, comprehensive treatment plans that incorporate physical therapy, nerve blocks, and possibly spinal cord stimulation may help slow the progression and maintain as much mobility and function as possible.

Late (Atrophic) Stage

Over time, CRPS can enter the atrophic stage, where the limb’s tissues become rigid and weak. Stiffness and a limited range of motion are common, and the skin may appear thin, pale, or even cooler compared to the rest of the body. These changes can be challenging to reverse and, in some cases, may be irreversible if aggressive treatment is not pursued. Although pain can diminish in certain individuals, the reduced function and structural alterations in bones, muscles, and joints can significantly impact daily life. Prompt medical intervention earlier in the CRPS journey can often prevent or minimize the long-term challenges seen in this final stage.

Diagnosing CRPS

Arriving at a CRPS diagnosis can be challenging due to the varied and sometimes subtle nature of its symptoms. At Greater Austin Pain Center, we start by reviewing your medical history, discussing your specific symptoms in detail, and performing a thorough physical examination. Diagnostic imaging such as X-rays, MRIs, or bone scans may be ordered to identify signs of bone demineralization or inflammation that often accompany CRPS. Additional tests—like nerve conduction studies or thermography—can help rule out other causes, while diagnostic nerve blocks may confirm whether certain nerves are driving the pain response.

It’s important to pursue early evaluation if CRPS is suspected. When addressed promptly, intervention strategies tend to be more successful, potentially minimizing long-term complications such as muscle atrophy or restricted mobility.

Treatment Approaches

Tackling CRPS effectively requires a multifaceted approach. In mild to moderate cases, physical rehabilitation and medication can significantly improve comfort and function. Physical therapy or occupational therapy focuses on exercises that maintain range of motion, boost muscle strength, and reduce the risk of joint stiffness. Some patients benefit from mirror therapy, which uses visual feedback to retrain the brain’s pain response in the affected limb.

When pain is more severe or fails to respond to first-line therapies, advanced interventions become necessary. Nerve blocks can intercept pain signals at the source, while spinal cord stimulation involves a small device that modifies nerve activity before it reaches the brain. Sympathetic ganglion blocks are sometimes employed when overactive sympathetic nerves perpetuate pain signals, and intrathecal pump systems may help deliver targeted medication directly to spinal fluid. Psychological support is also crucial for addressing the mental and emotional toll of CRPS; chronic pain can trigger depression, anxiety, and social withdrawal, and therapies like cognitive-behavioral therapy (CBT) can offer valuable coping strategies.

How Greater Austin Pain Center Can Help

At Greater Austin Pain Center, we recognize that every CRPS journey is unique. Our medical team draws on extensive experience with nerve pain conditions to craft a personalized plan that addresses both immediate discomfort and long-term well-being. We are proud to offer:

• Advanced diagnostic evaluations to identify the source of your pain using imaging techniques, nerve conduction studies, and thorough clinical assessments.
• Comprehensive treatment plans may incorporate physical therapy, medications, nerve blocks, spinal cord stimulation, and other interventional pain management strategies.

With convenient locations in San Marcos, Kyle, and across the Austin area, our goal is to restore function, reduce pain, and help you regain independence. If you suspect that you or a loved one may be dealing with CRPS, contact Greater Austin Pain Center today to discuss your symptoms and explore potential treatment options. Our team is committed to delivering the highest level of care and empowering you to overcome the challenges posed by this complex condition.