Pediatric complex regional pain syndrome (CRPS or RSD)

What is pediatric complex regional pain syndrome (CRPS or RSD)?

Complex regional pain syndrome (CRPS) – also known as reflex sympathetic dystrophy (RSD) – is a chronic pain syndrome that most often affects one arm, leg, hand, or foot following injury or trauma. CRPS is believed to be caused by damage to, or malfunction of, the peripheral and central nervous systems and presents as prolonged or excessive pain and mild or significant changes in skin color, temperature, and/or swelling in the affected area.

Risk factors

It’s more common in adults; rarely affects children younger than 10; and is not uncommon in teenagers.

What are the signs and symptoms of pediatric complex regional pain syndrome (CRPS or RSD)?

Symptoms of CRPS vary, but the most common symptom is prolonged pain in one area. Your child’s pain may be constant, and can range from mildly uncomfortable to severe. Your child may complain of a burning, squeezing, or “pins and needles” sensation, and pain can spread throughout an entire arm or leg. Your child’s limb may also be sensitive to touch.

Children with CRPS may also experience:

• Constant or intermittent changes in temperature, skin color, and swelling of the affected limb

• Changes in skin over the affected area

• An abnormal sweating pattern in the affected area

• Changes in nail and hair growth

• Stiffness in an affected joint

• Problems coordinating muscle movements

• Abnormal movements – like tremors, jerking, or fixed postures – of the affected limb

How is pediatric complex regional pain syndrome (CRPS or RSD) diagnosed?

Your child’s provider will ask about any history of injury or trauma to the area and look for symptoms that match the syndrome. He or she may also order tests to rule out arthritis, Lyme disease, and various muscle and nerve problems.

What are the causes of pediatric complex regional pain syndrome (CRPS or RSD)?

Providers aren’t sure what causes some people to develop CRPS. In more than 90 percent of cases, the condition is triggered by a trauma or injury, such as a fracture, sprain or strain, soft tissue injury (such as a burn, cut, or bruise), limb immobilization in a cast, or surgical or medical procedures.

How is pediatric complex regional pain syndrome (CRPS or RSD) treated?

The Pediatric Pain Management Center at Children’s Health offers many ways to manage pain associated with CRPS.

Your child’s providers may recommend one, or a combination of several, of these therapies:

• Acupuncture

• Anti-seizure or anti-depressant medications, which can ease  neuropathic pain

• Desensitization therapy

• Electrode nerve stimulation

• Exercise

• Lifestyle changes, such as weight loss or activity modifications

• Massage therapy

• Nerve blocks

• Pain relievers – over-the-counter or prescription

• Physical therapy (PT)

• Psychological counseling

• Occupational therapy (OT)

• Surgery

• Topical creams or patches