Complex Regional Pain Syndrome

Complex Regional Pain Syndrome is a nervous system response to chronic pain that involves small blood vessels and other systems that are under the control of the autonomic nervous system. The symptoms may be extremely varied and non-anatomical: feelings of crushing or twisting, or burning and prickliness will not generally follow the dermatomal or myotomal boundaries, nor correspond to specific muscles or specific regions of the central nervous system. Skin and bones are generally affected, and the symptoms may spread from one extremity to another without new injury.CRPS I relates to these responses after injury; CRPS II denotes the same family of symptoms following surgery. Theories of its origins, pathogenetic mechanism(s) and treatment are unproven at this time, but we have found the following theory and practical strategy to be helpful, though treatment may take a full year. Yoga is extremely helpful in the long run in our clinical experience. In CRPS the voluntary nervous system abandons a limb, to a varying extent, that is not always proportional to the pain, and the sympathetic nervous system gains more dominance, altering blood flow and affecting other functions, generally in the limbs. Yoga, and other straightforward activities gradually brings the voluntary nervous system into greater prominence, and that seems to genuinely relieve the condition, at least somewhat, over time. Other activities that help e.g., are drawing circles, squares, triangles and the like with a pencil held between the toes. Our greatest successes come from a general yoga program with beginning pranayama, focussing on intentional activity of the affected limb(s) and integrating them into larger bodily movements. REFERENCE: Schwartzman RJ, McLellan TL.Reflex sympathetic dystrophy. A review. Arch Neurol. 1987 May;44(5):555-61. https://www.ncbi.nlm.nih.gov/pubmed/3495254