Complex regional pain syndrome.

CRPS is a syndrome usually affecting one or more extremities, but may affect other parts of the body. It is a disabling disease with simultaneous involvement of nerve, skin, muscle, blood vessels, and bones. CRPS is characterized by “regional”, not focal, disproportionate pain and multiple symptoms in addition to pain, which may include changes in skin blood flow resulting in a warm or cool extremity, discoloration or mottling of the skin, sweating and swelling. The skin may become dry, scaly and atrophic. There may be hair and nail changes. The joints may be tender and swollen. The individual typically shields the limb from contact and use due to extreme pain with even normal or light touch. With time, and particularly without adequate treatment, the syndrome progresses to include permanent changes in the skin, hair, nails and soft tissue along with muscle wasting and loss of joint motion and contractures. The bones may become osteoporotic from disuse. Some individuals develop tremor, muscle spasm and difficulty initiating movement. Edema or swelling of the extremity can be marked and intermittent. Chronic skin breakdown and ulceration may develop.