Difference between CRPS1 and 2

[BethAnna]

I've been told that the difference between CRPS 1 (RSD) and CRPS 2 is 1 is due to an injury (I broke my left ankle and foot.) and 2 is due to specific nerve injury (I injured a disc in my C spine which injured the nerve roots to my arms.)

I've also been told (from a different source) that CRPS 2 is generally a more aggressive, more severe form of the CRPS's - it spreads faster, and is much more difficult to treat.  

I'd like your opinion on the second statement. . .there is precious little information out on CRPS2 and not much more on CRPS1.  

Thanks,
BethAnna

[dr_simran]

Hello BethAnna,
Complex Regional Pain Syndrome (CRPS) is a chronic progressive disease characterized by severe pain, swelling and changes in the skin. The International Association for the Study of Pain has divided CRPS into two types based on the presence of nerve lesion following the injury.
• Type I, also known as Reflex Sympathetic Dystrophy (RSD), Sudeck's atrophy, Reflex Neurovascular Dystrophy (RND) or Algoneurodystrophy, does not have demonstrable nerve lesions.
• Type II, also known as Causalgia, has evidence of obvious nerve damage.
The cause of this syndrome is currently unknown. Precipitating factors include illness, injury and surgery, although there are documented cases that have no documentable injury to the original site.
The pathophysiology of CRPS is not fully understood. “Physiological wind-up” and central nervous system (CNS) sensitization, are key neurologic processes that appear to be involved in the induction and maintenance of CRPS.
There is compelling evidence that the N-methyl-D-aspartate (NMDA) receptor has significant involvement in the CNS sensitization process.
The symptoms of CRPS usually manifest near the site of an injury, either major or minor, and usually spread beyond the original area. Symptoms may spread to involve the entire limb and, rarely, the opposite limb. The most common symptom is burning pain. The patient may also experience muscle spasms, local swelling, increased sweating, softening of bones, joint tenderness or stiffness, restricted or painful movement, and changes in the nails and skin.
The pain of CRPS is continuous and may be heightened by emotional stress. Moving or touching the limb is often intolerable. Eventually the joints become stiff from disuse, and the skin, muscles, and bone atrophy. The symptoms of CRPS vary in severity and duration. There are three variants of CRPS, previously thought of as stages. It is now believed that patients with CRPS do not progress through these stages sequentially and/or that these stages are not time-limited. Instead, patients are likely to have one of the three following types of disease progression:
1. Type one is characterized by severe, burning pain at the site of the injury. Muscle spasm, joint stiffness, restricted mobility, rapid hair and nail growth, and vasospasm (a constriction of the blood vessels) that affects color and temperature of the skin can also occur.
2. Type two is characterized by more intense pain. Swelling spreads, hair growth diminishes, nails become cracked, brittle, grooved, and spotty, osteoporosis becomes severe and diffuse, joints thicken, and muscles atrophy.
3. Type three is characterized by irreversible changes in the skin and bones, while the pain becomes unyielding and may involve the entire limb. There is marked muscle atrophy, severely limited mobility of the affected area, and flexor tendon contractions (contractions of the muscles and tendons that flex the joints). Occasionally the limb is displaced from its normal position, and marked bone softening is more dispersed


Refer: http://en.wikipedia.org/wiki/Complex_regional_pain_syndrome

Best

[Gstine]

I  was hurt in the rt elbow area after having surgery the upper part of my arm became super sensitive to touch even when the wind blows on it. I have been told I received CRPS after the surgery. Since the surgery I have loss the use of lifting or holding anything with my rt arm. My arm is red  and swells a lot. I put heat and ice back and forth on my arm to help the swelling and movement in my arm. my finger nails break off easy and now when they grow back they are very ruff. I have loss movement in my arm at the shoulder elbow and wrist area.  I have saw three doctors two state I have CRPS two and one is stating CRPS with nerve damage. What can I do now ?

[Nankimber]

See a pain specialist it helped me and now i am in remission in my ankle, i had 16 spinal blocks, but they worked to relieve my pain. my leg was a reddish purple when i startedand now it is normal.