Complex Pain

Complex Pain Treatment by Dr. Vivek Loomba

Complex Pain is a comprehensive term used to describe chronic pain (severe pain) that usually affects an arm or leg in the body. It is also known as Complex Regional Pain Syndrome (CRPS) where symptoms of pain range from mild to severe and may last for months or even years. It happens due to an injury, surgery, stroke, or heart attack. It can cause persistent pain that can hamper your health resulting in a high level of neurological conditions. Females get affected three times more than males, especially around the limb area on arm.

Symptoms of Complex Pain

Complex Regional Pain Syndrome can cause severe pain such as burning, stabbing, or throbbing pain. The affected area is swollen and highly sensitive to touch. You may not be able to use your arm or leg for quite some time. Even the lightest weight on the affected area can cause severe unbearable pain. Let’s see all the major symptoms complex pain can cause –

• Burning sensation pain in the arm, hand, leg, or foot.
• Stiffness
• Pain that ranges from high to low intensity
• Tremors or spasms
• The affected area is colder or warmer than other areas
• The affected area is painful and swollen
• Color or temperature change 
• Changes to hair or nail color
• More or less sweating
• Shaky movements

In addition to that, the patients suffering from chronic pain usually face some mental side effects too from anxiety and depression leading to negative feelings.

Causes of Complex Pain

Complex Regional Pain Syndrome (CRPS) is a painful condition that can affect different body systems. There are several factors that can cause complex pain to occur including –

• Surgery – Certain past surgery forms incisions, stitches, or scarring which can cause nerve injury resulting in complex pain.
• Sprains or strains – Excessive movement of joints due to some physical activities can lead to sprain or strain on nearby nerves.
• Burns, bruises, or injury – It affects the bones and nerves in the body causing long-lasting pain.
• Poor nerve health – An underlying health condition such as diabetes can affect the nerves and make them weak. Also, people with peripheral neuropathy find it difficult to regrow nerves which can cause problems. 
• Immune system – It plays a huge role in inflammation and autoimmune diseases. People with CRPS lack cytokine hormone resulting in low recovery from pain.
• Genetics – Family clusters of CRPS are also often linked with your recovery from injury. 

Diagnosis

There is no specific diagnostic test for determining that a person has CRPS. However, your healthcare provider performs a physical examination and tests to determine the condition. The tests that will be usually performed for diagnosis are –

• X-ray or bone scan
• Blood tests
• Magnetic Resonance Imaging (MRI) scan
• Regional or local Anesthesia
• Ultrasound
• Electromyography (EMG)

Treatment

There is a range of treatments for CRPS and it needs to be started at an early stage. Without any treatment, the condition may get worsen over time resulting in the stiffening of body parts. It will also affect your movement causing difficulty in the normal functioning of the body.  It is advisable to see a healthcare professional for treating CRPS to avoid further damage in the affected area. The treatments provided are –

• Physical and occupational therapy – A physical therapist will help you in increasing blood flow in the nerves for better recovery. While an occupational therapist will help you in managing your daily task. 
• Lifestyle changes – Eliminating certain lifestyle choices can help in the growth of new nerves such as quitting smoking and managing diabetes or blood pressure. 
• Psychosocial and behavioral therapy – People usually feel high levels of anxiety, depression, and stress while facing complex pain symptoms. Getting help from Psychotherapy can help in identifying your emotions to better cope with your disorder. 

• Medications – Over-the-counter medications are usually prescribed as a painkiller for managing your symptoms. The medications healthcare professionals usually recommend are Nonsteroidal anti-inflammatory drugs (NSAIDs) such as acetaminophen, ibuprofen, naproxen, antidepressants, Topical analgesic creams, patches, or anti-seizure drugs. 

• Alternative therapies for pain management – The alternative therapies they usually recommend are acupuncture, hypnosis, reiki, and chiropractic adjustments.

Complex Regional Pain Syndrome (CRPS) is usually difficult to prevent from occurring as researchers have no idea of the root cause of the disorder. However, there are many treatment options to reduce the pain that will significantly help in improving the quality of life. Earlier diagnosis is beneficial in providing better efficacy to your health and recovery. Also, if you experience prolonged symptoms of complex pain regularly it is advisable to seek professional help from your healthcare provider.