What Is CRPS?

Complex Regional Pain Syndrome (CRPS) can develop after an injury to an arm or leg — even a minor one, most often a fracture — where the nervous system's protective response becomes disproportionate to what the injury itself would typically cause. Inflammatory, immune, and nervous-system changes combine to amplify pain signals well beyond what the tissue damage explains. Your pain is real, measurable, and not something you're imagining or exaggerating.

Type I

  • No confirmed nerve injury (formerly "reflex sympathetic dystrophy")

  • The large majority of CRPS cases

  • Same symptoms as Type II, different starting point

Type II

  • Follows a confirmed nerve injury (formerly "causalgia")

  • Less common than Type I

  • Clinically looks the same as Type I in most respects

By the Numbers

3–4:1

women affected more often than men

~45%

of cases follow a fracture — the most common trigger

Any age

though onset is most common in mid-adulthood

How It's Diagnosed: The Budapest Criteria

Diagnosis requires pain out of proportion to the injury, plus symptoms and signs spanning at least three of these four categories — with no other diagnosis that better explains them:

The four Budapest Criteria categories:

  • Sensory — burning pain, or heightened sensitivity to touch or temperature

  • Vasomotor — skin temperature or color changes (redder, paler, or blotchy)

  • Sudomotor/Edema — swelling, or changes in sweating in the affected area

  • Motor/Trophic — reduced motion, weakness or tremor, or changes in hair, nail, or skin growth

Why Movement Matters, Even When It's Hard

It's natural to want to protect a painful limb by keeping it still. But with CRPS, prolonged guarding tends to make the nervous system more sensitive, not less — the brain's map of that limb becomes distorted, and pain circuits become more easily triggered. Gentle, graded movement — started small and built up carefully — is one of the most effective tools we have for calming that response while keeping the limb functional.

Graded Motor Imagery: Retraining the Brain-Body Connection

This three-stage approach re-engages the brain's motor pathways in a carefully sequenced way that avoids triggering a protective pain flare:

  1. Laterality training — identifying photos of hands or feet as left or right retrains accurate body mapping in the brain before any movement is asked of the limb.

  2. Imagined movement — mentally rehearsing moving the affected limb activates the same motor-planning brain regions as real movement, without physically moving it.

  3. Mirror therapy — watching the reflection of your unaffected limb move in place of the affected one gives the brain convincing visual feedback that movement is happening safely.

How We Approach CRPS Together

Treatment is gradual and layered — we meet your nervous system where it is:

  • Start where you are — desensitization, laterality training, or mirror therapy can calm the nervous system before movement even happens

  • Build up slowly — small, tolerable doses of movement, expanded a little at a time as tolerance grows

  • Coordinate care — the best outcomes come from a team: physical therapy, your physician, and often psychological support working together

  • Track more than pain — function, sleep, mood, and confidence all matter alongside pain itself

Bottom line: Earlier diagnosis and treatment are strongly linked to better outcomes, and CRPS is variable — some people improve substantially, and even long-standing cases can respond to the right approach. With the right team and a gradual, consistent plan, most people see meaningful improvement in pain, function, and quality of life. You're not alone in this, and we're glad to be part of your care.