How Complex Regional Pain Syndrome Is Diagnosed
There is no sure test for complex regional pain syndrome (CRPS), which used to be called reflex sympathetic dystrophy (RSD). Therefore, diagnosing CRPS is challenging and is made by excluding other conditions. Doctors and patients just have to watch the symptoms over time—the hallmarke of diagnosis is a thorough physical exam of signs and symptoms. But, they can get a little help from bone scans (MRIs), x-rays, touch tests (nerve testing), and other assessments to diagnose CRPS.
Patients with mild cases of CRPS may appear to have other illnesses such as lupus, chronic fatigue syndrome, muscular dystrophy, or a nerve entrapment. Their doctors will be watching to see which condition or conditions arise. Nevertheless, mild cases are less common than moderate or severe cases.
A doctor will suspect CRPS if you have a combination of these symptoms:
- intense pain in your feet, hands, legs, or arms
- a new pattern of rapid hair growth
- dramatic changes in the shape or color of nails
- visible changes in blood vessels
- pain that grows worse over time
- swollen or stiff joints
- pain that spreads to another hand, foot, leg, or arm
- decreased ability to move limbs, hands, and feet
- skin hypersensitivity
- skin that is a different temperature than skin on the rest of the body
- skin color changes
- sweating on one side of the body or on just one limb
In moderate and severe cases, these symptom combinations can appear in 1 to 3 months.
Other diagnosis tools health care professionals use to diagnose CRPS/RSD include:
- bone scans and x-rays to identify early bone deformities from CRPS/RSD
- skin sensitivity tests
- thermography to measures changes in blood supply and skin temperature
- nerve conduction studies to observe nerve behavior
- 2 or more MRI scans to monitor changes in skin, muscles, blood vessels, and other tissues
When a primary care physician gathers evidence suggesting you may eventually be diagnosed with CRPS, he or she should refer you to a neurologist for ongoing diagnostic work and treatment. The neurologist will monitor you with frequent visits, while providing pain management and prescriptions, and arranging for physical therapy and social support.
Many neurologists will begin to treat patients for CPRS/RSD even before they are sure of a diagnosis. Aggressive and early treatments are often helpful at relieving misery and slowing down the intensity of CRPS.