Signs and Symptoms of CRPS

According to many experts, the symptoms of CRPS (sometimes called RSD) often progress in three stages—acute, dystrophic and atrophic. The primary symptoms of CRPS is continuous, severe pain that gets worse over time, rather than better, and is not in proportion to the injury—if trauma has occurred. Usually CRPS affects one extremity (e.g., arm, leg, hand, foot).

The acute stage occurs during the first 1–3 months and may include

  • burning pain
  • swelling
  • increased sensitivity to touch
  • increased hair and nail growth in the affected region
  • joint pain
  • color and temperature changes

The dystrophic stage may involve constant pain and swelling. The affected limb may feel cool to the touch and appear bluish in color. Muscle stiffness, wasting of the muscles (atrophy) and early bone loss (osteoporosis) also may occur. This stage usually develops 3–6 months after onset of the disorder.

During the atrophic stage, the skin becomes cool and shiny, increased muscle stiffness and weakness occur, and symptoms may spread to another limb. At this stage, changes to the skin and bone usually are permanent.

Characteristic signs and symptoms of sympathetic nervous system involvement include the following:

  • Burning pain
  • Extreme sensitivity to touch
  • Skin color changes (red or bluish)
  • Skin temperature changes (hot or cold)

Pain caused by RSD/CRPS usually in not proportionate to the degree of injury. It can be triggered by disuse of the affected limb or by stress and can be spontaneous or constant.

Symptoms associated with an immune reaction include:

  • Joint pain
  • Redness
  • Swelling (edema)
  • Frequent infections

Signs of motor system dysfunction include the following:

  • Difficulty starting movement
  • Increased muscle tone, stiffness
  • Muscle spasm
  • Tremor
  • Weakness

Other symptoms of RSD/CPRS include the following:

RSD/CRPS Complications

Patients with any chronic illness, including CRPS, often suffer from depression and anxiety. Skin, muscle, and bone atrophy (wasting) are possible complications of this syndrome. Atrophy may occur because of reduced function of the affected limb.

Publication Review By: Eric M. Schreier, D.O., F.A.A.P.M.R., Stanley J. Swierzewski, III, M.D.

Published: 31 Dec 1999

Last Modified: 04 May 2012