Complex Regional Pain Syndrome: what it is and how we help

Complex regional pain syndrome at a glance

Complex regional pain syndrome (CRPS) is a condition in which severe, persistent pain develops in a limb, usually after an injury, fracture or surgery, and is far greater than expected from the original injury. It involves changes in how the nervous system processes pain. Early diagnosis and active rehabilitation give the best chance of improvement, and many people do improve.

Symptoms of CRPS

• Burning, stabbing or throbbing pain in an arm, hand, leg or foot
• Extreme sensitivity to touch, even clothing or bed sheets
• Changes in skin colour, temperature and swelling
• Stiffness and reduced movement
• Changes to hair and nail growth
• A sense that the limb does not feel like your own

How is CRPS treated?

UK guidelines from the Royal College of Physicians recommend early rehabilitation, pain education, physiotherapy and occupational therapy, psychological support and medication where needed. Specialist pain services manage more severe cases.

How we support CRPS in Chiswick

• Physiotherapy: graded movement, desensitisation and graded motor imagery, paced carefully.
• Manual lymphatic drainage: very gentle work for swelling where touch is tolerated.
• Psychological support: for coping with chronic pain.
• Acupuncture: an option away from the affected area for some people, with limited evidence.
• Yoga and breathing: calming the nervous system.

What does the evidence say?

Early, graded rehabilitation and graded motor imagery have the best evidence. Keeping the limb moving and used, within tolerance, helps prevent stiffness and worsening. We work alongside your pain team.

What causes CRPS?

CRPS usually develops after an injury such as a fracture, sprain or surgery, although sometimes the trigger is minor. The exact cause is not fully understood, but it involves changes in the nerves, immune response, blood flow and how the brain processes signals from the affected limb. It is more common in women and after wrist fractures.

Can CRPS go away?

Many people improve significantly, especially when CRPS is recognised and treated early, and some recover fully within a year or two. For others it becomes a long-term condition that can be managed. Staying engaged with rehabilitation, even when progress feels slow, gives the best chance of improvement.

What is graded motor imagery?

Graded motor imagery is a step-by-step programme that retrains the brain's map of the painful limb. It starts with recognising left and right images of hands or feet, moves on to imagining movements, then uses mirror therapy before progressing to real movement. It has evidence in CRPS and is best guided by a physiotherapist.

What to expect at Omnia

Your first appointment covers your injury, diagnosis, treatment so far and how CRPS affects your day. Your physiotherapist assesses the limb gently and at your pace, then sets a graded plan that may include desensitisation, graded motor imagery and gradual movement. We can add psychological support and coordinate with your pain team.

What you can do at home

• Use the affected limb gently in daily tasks
• Gradually expose the skin to different textures
• Pace activity to avoid flares
• Contact Burning Nights CRPS Support for information

Related: fibromyalgia and rehabilitation. Omnia Lifestyle, Chiswick W4. Book online or call 020 4515 0000.