What is Complex Regional Pain Syndrome (CRPS)?

CRPS (previously referred to as Reflex Sympathetic Dystrophy/RSD) is a chronic pain disorder that can develop after traumatic injury and/or after an extended period of immobilization. While pain is typical following a traumatic injury or surgery, patients with CRPS experience a disproportionate amount of pain to an otherwise non-painful stimulus.

Essentially, the body’s nervous system is going into “fight or flight” mode and is overreacting to sensory inputs. Patients can also experience abnormal swelling, abnormal hair/nail growth, abnormal skin color, abnormal temperature changes, abnormal sweating, and decreased range of motion. There is no official test to diagnose CRPS. Rather, it is a diagnosis by exclusion primarily. While the therapists here at Ascend Hand Therapy are aware of CRPS and are familiar with its symptoms, only a physician can make the diagnosis.

“I have CRPS. Now what?” In addition to treatment by your physician and most likely a pain management doctor, therapy is an effective treatment for decreasing pain and increasing function. The primary treatment in therapy is something called stress loading or the “scrub and carry” program. Scrubbing consists of moving the affected extremity in a back/forth motion while weight bearing through the extremity for at least 3-5 minutes. Carrying consists of the literal carrying of a light weight or small object in the affected hand for at least 3-5 minutes at a time. These two activities provide something called proprioceptive input throughout the entire upper extremity. This input helps calm down the body’s nervous system that is overreactive. According to David Myers, OTR, CHT, MOT, Owner/COO of Ascend Hand Therapy, “The scrub and carry protocol is analogous to calming down a crying baby. The baby is crying, yet the baby has been changed, has been fed, and is not sick. So, what do you do? You rock the baby and pat his back to help him calm down. In a similar way, the scrub and carry program helps calm down a nervous system that has been overreactive and needs some soothing stimuli to ease its pain.”

Another important aspect to resolving CRPS is to use the affected extremity as normal and functional as possible, while keeping the pain level as low as possible. The old adage “no pain, no gain” is not entirely true in therapy, especially when treating CRPS. If activities that cause increased pain continue to occur, then the body is being trained that everything it does will hurt. As a result, the cycle of pain continues, and the symptoms listed above continue to occur or get worse. Engaging in activities that are functional but have minimal amounts of pain are important in regaining functional use of the affected extremity.

If you or someone you know is experiencing these types of symptoms, Ascend Hand Therapy is here to help. We accept most insurance plans and also offer a very reasonable cash price for self-pay patients. We look forward to helping you reach your goals by bringing your therapy to new heights!

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