Complex Regional Pain Syndrome (CRPS) is a chronic pain condition that typically develops in an arm or leg following an injury, surgery, or even a relatively minor trauma such as a sprain or fracture. What makes CRPS particularly challenging is that the pain experienced is often far more severe and long-lasting than would normally be expected from the original injury, and it’s frequently accompanied by visible changes in the skin, temperature, and swelling of the affected limb.
Because CRPS can be difficult to diagnose and easy to misunderstand, early recognition and specialist treatment are critical to preventing the condition from becoming more entrenched. Dr. Kavita Poply, a specialist in pain management and neuromodulation in London, provides a structured, multidisciplinary approach to CRPS, focusing on both pain control and restoring function in the affected limb.
What is Complex Regional Pain Syndrome (CRPS)?
CRPS is thought to result from an abnormal response of the nervous system following injury, where pain signalling becomes amplified and dysregulated well beyond the healing period of the original injury. It’s classified into two types: CRPS Type 1, which occurs without confirmed nerve damage (the more common form), and CRPS Type 2, which occurs following a clearly identified nerve injury.
The condition most commonly affects one limb, and while the exact mechanisms are still being researched, it’s understood to involve changes in how the central and peripheral nervous systems process pain, along with inflammatory and vascular changes in the affected area.
Causes and Triggers of CRPS
- Fractures, particularly of the wrist or ankle
- Surgery, including relatively minor orthopaedic procedures
- Sprains, strains, or soft tissue injuries
- Nerve injury (associated with CRPS Type 2)
- Prolonged immobilisation of a limb, such as in a cast
- In some cases, no clearly identifiable trigger at all
Symptoms of CRPS
- Severe, disproportionate pain relative to the original injury — often burning, throbbing, or aching
- Swelling of the affected limb
- Changes in skin colour (red, blue, or mottled) and temperature (warmer or cooler than the other limb)
- Changes in skin texture, sweating, or hair/nail growth patterns
- Extreme sensitivity to touch (allodynia), where even light contact is painful
- Stiffness, reduced range of movement, or weakness in the affected limb
- Tremor or changes in muscle coordination in more advanced cases
How We Diagnose CRPS
CRPS is primarily a clinical diagnosis, meaning there’s no single definitive test — instead, diagnosis relies on a detailed history, physical examination comparing both limbs, and internationally recognised diagnostic criteria (the Budapest Criteria) that assess the pattern of pain, swelling, temperature and skin changes, and motor symptoms. Additional investigations, such as imaging or nerve conduction studies, may be used to rule out other conditions or confirm nerve involvement in suspected Type 2 cases. Because CRPS symptoms can fluctuate, diagnosis often benefits from assessment over more than one visit.
Our Approach to Treatment
Comprehensive Diagnosis
A detailed clinical assessment using recognised diagnostic criteria, combined with any necessary investigations, to confirm CRPS and rule out other causes of limb pain.
Personalised Treatment Plan
Because CRPS varies significantly between patients in severity and presentation, treatment plans are individually tailored and often involve close coordination between pain management and physiotherapy.
Treatment Options
Pain Management: Targeted nerve blocks and, in appropriate cases, neuromodulation techniques to help interrupt the abnormal pain signalling associated with CRPS.
Medication: Nerve-pain medications and, where relevant, treatments aimed at the inflammatory component of the condition.
Physiotherapy: Graded motor imagery, desensitisation techniques, and progressive movement therapy — often a cornerstone of CRPS treatment to restore function and reduce pain sensitivity.
Lifestyle Modifications: Guidance on pacing activity, sleep, and psychological support, since chronic pain conditions like CRPS often benefit from a whole-person approach.
Advanced Treatment Options: For patients with more severe or treatment-resistant CRPS, advanced interventional pain management or neuromodulation options may be considered.
What to Expect During Recovery
Early treatment generally leads to better outcomes in CRPS, which is why prompt specialist referral is so important. Recovery is typically gradual and multidisciplinary, combining pain management procedures with structured physiotherapy over a period of weeks to months. Some patients achieve substantial resolution of symptoms, particularly with early intervention, while others require ongoing management to keep symptoms controlled — regular review allows the treatment plan to be adjusted as the condition evolves.
Why Choose Expert Care?
CRPS is a complex condition that’s frequently under-recognised, and delayed diagnosis can allow symptoms to become more entrenched and harder to treat. With a patient-centred, multidisciplinary approach, Dr. Kavita Poply ensures patients with suspected CRPS receive a timely, accurate diagnosis and a treatment plan focused on both pain relief and functional recovery.
Book Your Consultation
If you’re experiencing pain that seems disproportionate to an injury, along with swelling, temperature, or skin changes in a limb, early specialist assessment is important. Book your consultation today to begin your diagnosis and treatment plan.
Frequently Asked Questions
Q.1 Is CRPS permanent?
Ans. Not necessarily. Many patients, especially those diagnosed and treated early, see significant improvement or resolution of symptoms. Some patients experience a more chronic course requiring ongoing management, which is why early specialist input matters.
Q.2 Why does CRPS cause more pain than the original injury?
Ans. CRPS involves an abnormal amplification of pain signalling within the nervous system, meaning the level of pain no longer matches the severity of the original injury — this is a recognised feature of the condition, not a sign that the pain isn’t real.
Q.3 Can CRPS spread to other limbs?
Ans. In a minority of cases, symptoms can spread beyond the originally affected limb, which is one reason why early, effective treatment is emphasised to help limit the condition’s progression.
Q.4 Is physiotherapy safe if my limb is very painful?
Ans. Yes, but it needs to be carefully graded and supervised. A specialist physiotherapy approach designed for CRPS — starting gently and progressing gradually — is a key part of treatment rather than something to avoid.