HEALTH & WELLNESS
Severe limb pain needs immediate attention
Complex regional pain syndrome (CRPS), also
known as reflex sympathetic dystrophy syndrome
(RSDS), is a progressive disease of the autonomic
nervous system, specifically the sympathetic ner-
vous system. This uncommon form of chronic pain
has been characterized as constant and extremely
intense. However, the associated pain does not cor-
relate with the severity of the initial injury.
CRPS typically develops after an injury, surgery,
DR. RONNEN
ABRAMOV stroke or heart attack. This type of pain usually af-
fects one or more of the four limbs but may occur in
other parts of the body. Studies have shown that 70
percent of patients with the syndrome have had it spread to other
areas. It is ranked as the most painful form of chronic pain by the
McGill Pain Index.
This chronic pain condition occurs because high levels of
nerve impulses are sent to an affected site. Some experts believe
that CRPS is the result of a dysfunction of the central or periph-
eral nervous systems. It’s most common in people ages 20-35 and
affects women more often than men.
There are two types of CRPS. Type I is a simple trauma such as
a break or fracture, sharp force injury, heart problems, infections,
surgery or spinal disorder. Type II involves a major and highly de-
finable nerve injury.
In cases of injury-related CRPS, the syndrome may be caused
by the immune system triggering a response that leads to swell-
ing, redness and warmth. Some believe that CRPS represents a
disruption of the healing process.
72
NEW JERSEY COPS
■ FEBRUARY 2019
The four main symptoms that determine CRPS are:
Constant burning pain
•
• Inflammation
• Spasms
• Insomnia
The signs and symptoms of CRPS may change over time and
vary depending on the individual. The most common occurrence
is chronic burning pain, swelling, redness and hypersensitivity in
temperature changes.
Occasionally, CRPS may spread from its source to elsewhere
in the body, such as the opposite limb. Emotional stress also has
been known to worsen the pain.
Although the cause of the pain is not understood and there is
no cure, early treatment is recommended and found to be most
effective. Many patients who undergo interventional pain man-
agement see improvement and even go into remission.
If a person experiences severe and constant pain that affects
a limb and makes touching or moving it seem intolerable, he or
she needs to see a physician immediately to determine the cause.
Treatment must begin within months of onset to prevent any sig-
nificant probability of a long-term disability.
Dr. Ronnen Abramov, D.O., is board certified in pain management
and physical medicine and rehabilitation. He specializes in inter-
ventional procedures, including epidural steroid injections, facet
injections and sympathetic blocks. He is located at the Medical
Arts Pavilion, 5 Plainsboro Road, Plainsboro, N.J. 08526. For an
appointment, call 609-497-4371 or visit http://princetonpain-
management.com.