In short
CRPS is a painful condition that usually develops in an arm or leg after an injury, fracture or surgery. Pain is far greater than expected, with changes in colour, temperature, swelling or sweating. Early diagnosis and active rehabilitation give the best chance of recovery.
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What is CRPS?
Complex regional pain syndrome is a condition in which an arm or leg becomes severely painful, usually after an injury such as a fracture, sprain or surgery, though sometimes after a minor injury. The pain is far greater and lasts longer than would be expected from the original injury.
There are two types. CRPS type I happens without a confirmed nerve injury, and is the more common type. CRPS type II follows a confirmed nerve injury.
Symptoms
- Continuing pain that’s out of proportion to the injury, often burning
- Extreme sensitivity to touch or temperature
- Swelling
- Changes in skin colour or temperature compared with the other limb
- Changes in sweating
- Stiffness, weakness, tremor or difficulty moving the limb
- Changes in hair or nail growth
- A feeling that the limb doesn’t belong to you, or difficulty sensing where it is
Living with pain that hasn’t settled?
Talk it through with an Australian doctor online. No referral needed.
How is it diagnosed?
There’s no single test. Doctors use the Budapest criteria, which look for continuing disproportionate pain, plus specific symptoms and examination findings across four groups: sensation, blood flow and colour, swelling and sweating, and movement and skin changes. Other conditions that could explain the symptoms have to be ruled out first. Tests such as X-rays or scans may be used to check for other problems.
Treatment
Early, active treatment matters. The main approaches are:
- Physiotherapy and occupational therapy to keep the limb moving and restore function, even when it’s uncomfortable.
- Graded motor imagery and mirror therapy, which retrain how the brain represents the limb.
- Desensitisation, gradually getting the skin used to touch and textures.
- Pain education and psychological support.
- Medicines, which can help some people, particularly with sleep and nerve-type pain.
- Specialist pain care for people who aren’t improving.
Research on these treatments is still developing. A 2022 Cochrane review of physiotherapy for CRPS found the evidence was low certainty, but rehabilitation remains the foundation of care in guidelines.
Outlook
Many people improve, especially when CRPS is recognised and treated early. Some have symptoms that last for years. Getting a diagnosis and starting active treatment early gives the best chance.
When to see a doctor
See a doctor promptly if, after an injury or surgery, a limb becomes much more painful than expected, or develops swelling, colour or temperature changes, or sensitivity to light touch.
Next step: talk to a doctor
Answer a few quick questions and you’ll get an email about your eligibility. A consultation doesn’t guarantee any particular treatment.
References
- Harden NR, Bruehl S, Perez RSGM, et al. Validation of proposed diagnostic criteria (the "Budapest Criteria") for Complex Regional Pain Syndrome. Pain. 2010;150(2):268-274.
- Smart KM, Ferraro MC, Wand BM, et al. Physiotherapy for pain and disability in adults with complex regional pain syndrome (CRPS) types I and II. Cochrane Database Syst Rev. 2022;5(5):CD010853.
- Shafiee E, MacDermid J, Packham T, et al. Rehabilitation Interventions for Complex Regional Pain Syndrome: An Overview of Systematic Reviews. Clin J Pain. 2023;39(9):473-483.
- Cohen SP, Vase L, Hooten WM. Chronic pain: an update on burden, best practices, and new advances. Lancet. 2021;397(10289):2082-2097.
This guide is general information, not medical advice. It doesn’t replace a consultation with a doctor who knows your history. In an emergency, call 000.