CRPS After an Injury, Surgery or Fracture

Complex Regional Pain Syndrome

Often referred to as the “suicide disease,” CRPS is associated with imbalance and malfunction of the autonomic nervous system resulting in disability, impairment, chronic pain, and functional loss. It is a chronic disease that often worsens over time. The disease may remain localized, spread slowly over years, or progress rapidly like a wildfire out of control.

If you are suffering from Complex Regional Pain Syndrome, or you love or care about someone who suffers from CRPS, you’ve probably already asked yourself… “Why me?” “Why them?”“How did this happen?”

Often, patients will think – if only. If only I didn’t twist my ankle that day. If only I didn’t fall on that filing cabinet. If only I wasn’t in that car accident. I have news for you that might help you in some way.

Our hypothesis, and strong belief, based on all of Dr.Katinka’s experience and the hundreds of CRPS patients that we’ve treated: The accident that finally triggered your pain was not the only thing that caused your pain.

Top Common Symptoms Shared by CRPS Patients

It is crucial to explore the symptoms that often exist concurrently with CRPS, but that may not be commonly associated with it or may be treated as separate issues. These symptoms may be experienced in addition to the most common or obvious symptoms associated with CRPS. You may suffer from just a few, or if you are unlucky, from a long list of these.

CRPS Symptoms Associated with Nervous System Dysfunction

(Pain levels can vary greatly from person to person, ranging from mild to severe)

Loss of taste
Speech disturbances, which can be so severe that it sounds as if you have suffered from a stroke (sometimes, you may have a hard time finding words or putting them in the right order)
Balance loss
A feeling of fullness in your ears
Eye pain
Burning in eyes
Ever-changing eyesight and visual disturbances (if you are reading this book on an e-reader and had to change the font, this may be affecting you)
Light sensitivity
Blurred vision
Feelings of disorientation, especially when going to a store like Costco or Sam’s Club (these stores have large open spaces with no horizons, lots of visual stimulation, and the need for you to focus)
Feelings of disorientation while in an elevator
Fainting
Light-headedness
Nausea
Carsickness or disorientation while riding in a car, especially when you look at strobe lights like the ones that emergency vehicles use
Dizziness
Ears ringing
Ears buzzing
Intolerance to loud sounds, such as a baby crying
Hearing loss
Inability to tolerate large crowds
One-sided facial pain
Pain in your teeth
Jaw pain
Difficulty swallowing
Cystic acne
Rashes
Loss or thinning of lateral eyebrows
Eyes appearing “buggy,” like they are popping out
Bags beneath your eyes
Brown discoloration of patches of your skin (Melasma), commonly referred to as the “mask of pregnancy,” when you are not pregnant

The Categories of CRPS Symptoms

These days, the Budapest criteria are often used to diagnose CRPS. These categories are most widely used and were developed by pain clinics to differentiate between CRPS and other neuropathic conditions. These look at four main categories of symptoms as shown below:

Sensory abnormalities, such as an abnormal pain response to normal everyday sensory input. This includes directional pressure (such as being poked with a finger), light touch, circumferential pressure (such as putting on a tight sock), pain (being stabbed with a sharp object), cold, heat, exposure to humidity and vibration. Pain will also be perceived at a heightened intensity.
Vasomotor abnormalities, which include differences in skin temperature greater than 1 degree Celsius, and a difference in skin color when comparing one part or limb of the body to the opposite part or limb.
Sudomotor/edema, which include asymmetry in swelling and sweating.
Motor/trophic, which is defined as decreased movement, muscle or nerve weakness, tremors, and changes in hair, skin or nails.

CRPS is identified by these symptoms in the following way:

A: Ongoing pain than doesn’t match the original injury in intensity or duration
B: At least one symptom from two or more of the Budapest categories mentioned above
C: At least one symptom from three or more of the four Budapest categories mentioned above
D: A lack of alterative diagnosis

Symptoms of CRPS in Hands, Wrists, Arms, and Shoulders

(Pain levels can vary greatly from person to person, ranging from mild to severe)

Shoulder pain
Rotator cuff problems
Pain across your shoulders
Tense or “hard” upper back and shoulder muscles, or what I refer to as “concrete shoulders” in my office
Cannot lift either arm above shoulder level
Nerve pain or numbness in either (or both) shoulder(s)
Tension in either (or both) shoulder(s)
Pain in either (or both) arm(s)
Forearm pain
Finger pain
Cold hands
Inability to perform fine motor tasks (writing)
Swelling in either (or both) hand(s)
Pain in either (or both) wrist(s)
Pain in either (or both) hand(s)
Discoloration of fingers
Fingernail changes
Weak grip for example, when opening bottles
Dropping things a lot
Tingling in any part of the upper extremities
Burning in shoulders radiating from neck

Symptoms of CRPS in Knees, Legs, Hips

(Pain levels can vary greatly from person to person, ranging from mild to severe)

Pain in one or both legs
Knee pain/problems (even diagnosed arthritis)
Pain in one or both hips
Pain in buttocks
Cramps in your legs or feet
Restless legs
“Creepy-crawly” feeling in legs at night
If you are a female, extreme pain may be experienced while shaving your legs. One of my patients described it as a feeling similar to a razor being dragged over a thin layer of broken glass.

Symptoms of CRPS in Foot and Ankle

(Pain levels can vary greatly from person to person, ranging from mild to severe)

Pain in one or both ankles
Pain in one or both feet
Feeling of walking on broken glass
Numbness in either (or both) foot (feet)
Numb toes
Cold feet (not the kind you get before getting married)
Burning in either foot
Cramps in your legs or feet
Swollen ankles
Swollen feet
Pain in toes

Symptoms of CRPS in the Head and Neck

Headaches
Migraines
One-sided headaches
One-sided migraines
Pain in back of head or base of skull
Pain in either temple
Heavy” or “foggy” head
Memory loss (One of my patients calls this CRPS Tourette’s. Here is how she explained it: “Sometimes, things will pop into your head and then leave just as readily. Therefore, I have learned to spit it out the second I think of it. Sometimes my family will be discussing something completely unrelated to shopping, and I’d say “Apples! We need Apples!” Therefore, CRPS Tourette’s.)
Neck pain
Pain when moving your neck
Stiff neck
Muscle spasm
Neck “grinds” or “pops”
Difficulty in moving the neck
Nerves feel “pinched”
Disc problems
TMJ (temporomandibular joint) pain and problems
Pain in the face (trigeminal neuralgia)
Pain radiating into teeth
Clenching your teeth at night
Teeth grinding
Pain that radiates into your teeth
Pain when chewing food

Symptoms of CRPS in the Lower Back, Midback & Chest

Low Back

Low back pain
Muscle spasms
Stiff low back
Arthritis
Disc problems, such as herniated discs
Arthritis in the lower back
Decreased movement of the lower back
Pain down the thigh to the knee or the foot (pain may originate below knee)

Midback and Chest

Tender muscles in anterior chest
Midback pain
Pain when wearing a bra
Pain between shoulder blades
Midback spasms
Pain when you get a massage
Chest pain
Pain in your breastbone
Pain that feels like it’s coming from your heart
Shortness of breath
Pain in your ribs (in the front or back)
Difficulty breathing

Symptoms of CRPS in the Abdomen / Stomach

Gas
Nausea
Constipation
Cramping
Discomfort after eating
Fatigue after eating
Loss of appetite
Diarrhea
Crohn’s disease
Irritable bowel syndrome (IBS)
Heartburn
Gluten intolerance/allergies
Menstrual pain
Cramping
Irregularity
Heavy cycles
Abdominal pain
Irritated stomach
Abnormal pap smears
Ovarian cysts
Infertility
Impotence
Inability to have an orgasm

CRPS Triggers and Catalysts

CRPS (Complex Regional Pain Syndrome) triggers and catalysts refer to various factors, events, or conditions that can exacerbate or activate the symptoms of CRPS in individuals who are already predisposed to the condition. These triggers and catalysts can lead to an escalation of pain, inflammation, and other manifestations of CRPS.

While CRPS is a complex condition with multiple contributing factors, certain triggers and catalysts may include:

Physical Injury or Trauma:

A specific injury, surgery, or trauma can act as a trigger for CRPS. Even minor injuries may lead to an abnormal response in the nervous system and contribute to the development of CRPS.

Neck injury

Spinal injury

Fractures, one of the most common cause of CRPS, especially wrist fractures ( distal radius fractures)

Sprains and strains (such as, CRPS after an ankle sprain)

Burns and cuts

Deep wounds and lacerations

Limb immobilization (such as wearing a cast)

Please note that the force of the impact or the time that has gone by since the injury often has no effect on the extent of the injury.

Surgery or Medical Procedures:

Surgical interventions, especially those involving nerves or joints, can potentially initiate or worsen CRPS symptoms. CRPS after surgery commonly seen:

CRPS after ankle surgery

CRPS after back surgery

CRPS after foot surgery

CRPS after hand surgery

CRPS after knee surgery

CRPS after knee replacement

CRPS after spine surgery

CRPS after shoulder surgery

CRPS after wrist surgery

Additional catalysts and triggers:

Infections: Underlying infections, such as bacterial or viral infections, can trigger an immune response that affects the nervous system and contributes to CRPS symptoms.

Nervous System Dysregulation: Any event that disrupts the normal functioning of the nervous system, such as trauma or surgery, can serve as a catalyst for the development of CRPS.

Genetic Predisposition: Genetic factors may make certain individuals more susceptible to developing CRPS, and specific genetic traits can contribute to the expression of symptoms.

Inflammation: Chronic inflammation in the body, whether due to injury, infection, or other causes, can play a role in the initiation and progression of CRPS.

Emotional Stress or Trauma: Psychological stressors or trauma may influence the nervous system's response and contribute to the manifestation of CRPS symptoms.

Autoimmune Responses: Abnormal immune responses may contribute to the development of CRPS, as the immune system may target healthy tissue, leading to pain and inflammation.

Temperature Changes: Exposure to extreme temperatures or changes in temperature can trigger or worsen CRPS symptoms, leading to increased pain and sensitivity.

Movement and Activity: Certain movements or activities that stress the affected limb or area may trigger CRPS symptoms or exacerbate existing pain.

Hormonal Fluctuations: Hormonal changes, such as those associated with menstruation or menopause, may influence the nervous system and impact CRPS symptoms.

Underlying Health Conditions: Pre-existing health conditions, such as autoimmune disorders, may contribute to the development or worsening of CRPS.

It's important to note that individual responses to triggers and catalysts can vary widely, and not everyone exposed to these factors will develop CRPS. Understanding potential triggers and catalysts can help individuals with CRPS manage their condition and make informed decisions about their treatment and lifestyle choices.

World's Leading Program for CRPS after an Injury

Healing CRPS Pain from the inside out

CRPS

Complex Regional Pain Syndrome

Top Common Symptoms Shared by CRPS Patients

CRPS Symptoms Associated with Nervous System Dysfunction

The Categories of CRPS Symptoms

Symptoms of CRPS in Hands, Wrists, Arms, and Shoulders

Symptoms of CRPS in Knees, Legs, Hips

Symptoms of CRPS in Foot and Ankle

Symptoms of CRPS in the Head and Neck

Symptoms of CRPS in the Lower Back, Midback & Chest

Symptoms of CRPS in the Abdomen / Stomach

CRPS Triggers and Catalysts

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