Complex regional pain syndrome (CRPS) is a long‑lasting pain condition, usually affecting an arm or leg, where pain continues after an injury or surgery and is much more severe than would normally be expected. The affected limb can become extremely sensitive, with burning pain, colour or temperature changes and stiffness that make everyday tasks difficult and affect quality of life.
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Complex regional pain syndrome (CRPS)
Also known as: reflex sympathetic dystrophy (RSD), Sudeck’s atrophy, chronic regional pain syndrome
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CRPS symptoms
CRPS symptoms often begin weeks after an injury, operation or even a minor trauma and may change over time. The condition usually affects one limb, but symptoms can sometimes spread to other areas.
Common symptoms include:
- Continuous burning, throbbing or stabbing pain, often out of proportion to the original injury.
- Extreme sensitivity to touch, temperature or even clothing, where light contact can cause intense pain (allodynia).
- Changes in skin colour, temperature or texture – the limb may appear red or blotchy, feel warmer or cooler than the other side, or become shiny or thin.
- Swelling, stiffness and reduced range of movement in joints, making it hard to use the affected hand, arm, foot or leg.
- Changes in hair and nail growth, muscle weakness or muscle wasting if the limb is not moved regularly.
Symptoms can vary day to day and may worsen with stress, tiredness or colder weather.
What causes CRPS?
The exact cause of CRPS is not fully understood, but it is thought to involve an abnormal response in the nervous system and immune system after an injury. Messages between the affected limb, spinal cord and brain become over‑sensitive, so that normal sensations are experienced as severe pain and the body’s natural inflammatory response is prolonged.
CRPS most commonly develops after:
- A fracture, sprain, soft‑tissue injury, limb immobilisation in a cast or surgery on an arm or leg.
- Nerve damage or crush injuries, sometimes referred to as CRPS type II.
- Occasionally, no clear trigger can be identified, but the pain and other symptoms are still very real and require expert assessment and support.
Early diagnosis and a multidisciplinary treatment approach give the best chance of reducing pain, improving movement and preventing long‑term disability.
Can CRPS be prevented?
CRPS cannot always be prevented, but certain steps around the time of injury or surgery may help lower the risk. Maintaining gentle movement of the limb where safe, following physiotherapy advice and controlling pain effectively in the early stages may support more normal healing.
If you have had CRPS before, let your healthcare team know before any future operations or procedures so that a tailored pain‑management plan can be put in place. Prompt referral to a specialist pain or neuromodulation team is also important if severe pain starts to develop after an injury and is not responding to usual painkillers.
When to see a consultant
You should seek specialist advice if you have persistent, severe limb pain after an injury or operation that feels out of proportion to what you would expect, particularly if it is worsening rather than improving over time. Other reasons to see a consultant include new sensitivity to light touch or temperature, noticeable colour or temperature changes in a limb, or increasing stiffness and difficulty using your hand, arm, foot or leg.
At The London Clinic, consultants with expertise in chronic pain, neuromodulation and rehabilitation can assess complex regional pain syndrome in detail, help confirm the diagnosis and work with you on a personalised plan to relieve pain and support day‑to‑day function.
CRPS diagnosis
There is no single test for CRPS, so diagnosis is based on your symptoms, examination findings and ruling out other causes of limb pain and swelling. Your consultant will talk to you about the injury or event that triggered your symptoms, how the pain has changed over time and how it affects your life, and will examine the affected limb for changes in sensation, temperature, colour, swelling and movement.
Investigations such as blood tests, X‑rays, MRI scans or bone scans may be arranged to exclude infections, fractures that have not healed properly or other conditions such as arthritis or nerve entrapment. Your care often involves a multidisciplinary team including pain specialists, physiotherapists, occupational therapists and psychologists, because CRPS can affect both physical function and emotional wellbeing.
Treatment options
Although CRPS can be challenging, many people improve with early, coordinated treatment that focuses on reducing pain, restoring movement and supporting emotional health. Your treatment plan at The London Clinic is tailored to your symptoms, how long you have had them and any previous treatments you have tried.
Understanding CRPS and how pain mechanisms work can help you feel more in control and make the most of your treatment plan.
Gentle, graded exercises and movement techniques help maintain flexibility and strength, improve confidence using the limb and prevent long‑term stiffness.
Depending on your symptoms, options may include neuropathic pain medicines, anti‑inflammatories, bone‑strengthening drugs or other pain‑modulating treatments. Your consultant will explain potential benefits and side effects and review medicines regularly.
Long‑term pain can affect mood, sleep and relationships, so psychological therapies such as cognitive behavioural therapy (CBT) and pain‑management programmes can be an important part of care.
In selected cases, nerve blocks or injections may be used to target pain pathways and support participation in rehabilitation.
Neuromodulation and advanced therapies at The London Clinic
If pain remains severe and disabling despite comprehensive conservative treatment, neuromodulation may be considered as an advanced option. Spinal cord stimulation (SCS) is a type of neuromodulation that uses a small implanted device to deliver gentle electrical impulses to the spinal cord, helping to block or alter pain signals before they reach the brain. SCS has been shown to provide meaningful relief and improve quality of life for some people living with complex regional pain syndrome.
At The London Clinic, experienced consultants in neuromodulation and pain medicine offer a structured pathway, including careful assessment, a temporary stimulation trial to see how well it works for you, and ongoing follow‑up to fine‑tune your device settings and broader pain‑management plan. Your team will discuss all suitable options with you and support you in deciding whether neuromodulation, rehabilitation‑based care or a combination of approaches is right for your needs.
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Disclaimer
Complex regional pain syndrome (CRPS) can sometimes develop after a stroke and may need discussion within a multidisciplinary team (MDT). Treatment often works best when several specialists are involved, and consultants at The London Clinic can refer you on to other experts, such as a neurologist, if needed.