What does CRPS do to your Nails?

How CRPS Manifests in Nail Changes

In the early stages of CRPS, some patients experience rapid nail growth, with nails appearing stronger than usual. However, as CRPS advances, the changes often become more severe. In later stages, the nails may start to display cracks, pits, and grooves. Discoloration or the appearance of spots on the nails is also common, adding to the list of visible markers that CRPS is affecting the body beyond pain and swelling. These changes to the nails reflect the larger disruptions happening within the body, as CRPS impacts blood flow, nerve signals, and overall cellular health.

Common Nail Changes in CRPS

In CRPS, nail health can deteriorate in various ways as the condition progresses. Here are some of the changes you might notice:

• Rapid Growth: In some cases, especially during the early phase of CRPS, known as “Stage 1” or “wet CRPS,” nails might grow faster than usual. This stage is also characterized by burning pain, muscle spasms, restricted mobility, and other symptoms. For some individuals, the initial stage may be brief, and symptoms may even resolve on their own. However, most patients experience progression, with further symptoms developing.
• Brittle or Grooved Nails: As CRPS advances, nail health often suffers more severely. In what was once referred to as Stage 2, nails may become brittle, crack, develop grooves, or even display spots. This stage is marked by intensified pain, often described as a “burning alive” sensation, swelling, muscle atrophy, and even osteoporosis. The nail irregularities reflect the changes occurring deeper within the affected limb or body part.
• Permanent Nail Changes: In the most advanced cases of CRPS, also known as “Stage 3,” the damage to nails can become permanent. Accompanied by extreme pain and permanent changes to the skin and bones, nails may no longer grow normally. The entire limb may be affected, with symptoms spreading to other body parts, such as the optic nerves or digestive system.

Why Nail Health Is Affected by CRPS

The nail changes seen in CRPS patients stem from the syndrome’s effect on the central nervous system, which regulates many autonomic functions, including blood flow and temperature. CRPS can lead to a vasomotor response—irregularities in blood vessel control—which impacts nail growth and health. Affected limbs may receive inconsistent blood supply, leading to changes in nail structure and quality. Additionally, CRPS impacts the motor and trophic functions of the body, which encompass the growth and condition of skin, hair, and nails.