Complex regional pain syndrome is a condition characterized by onset of chronic pain that affects an arm or a leg. It is a rare form of disease and the type II variety often results from nerve injury.
The following are the various signs and symptoms experienced by individuals affected by complex regional pain syndrome type II .
A preliminary physical examination, coupled with past medical history would be taken initially. This would be followed by several diagnostic methods to accurately judge the condition.
If treatment is initiated within first few months of onset of symptoms, then the condition can be effectively managed with medications and therapies. The following methods are administered for treatment of complex regional pain syndrome type II.
Various pain relieving medications are employed for helping the patients deal with pain. Other class of medications to manage other symptoms is also employed. These include anticonvulsants, corticosteroids, intravenous ketamine and sympathetic nerve blocking medications. Research has shown tha, ketamine given intravenously helps in relieving the pain .
Various types of therapies that involve physical therapy, biofeedback and transcutaneous electrical nerve stimulation are beneficial. In addition to these, analgesics to be applied on the area are also provided. A new mode of therapy has been introduced known as the spinal cord stimulation therapy. In this, tiny electrodes are inserted along the spinal cord in order to provide relief .
If treatment has been initiated within 3 months of first appearance of the signs and symptoms then a good prognosis can be expected. However, if there is delay in initiation of treatment, the disease can rapidly affect the entire limb causing irreversible damage to the bones, nerves and muscles. In addition, affected individuals can suffer from atrophy of muscles and in many cases, limb amputation may be required .
Complex regional pain syndrome type II majorly occurs due to nerve injury that can results from various factors. These include crush injuries, surgery, forceful trauma to the arm and leg, heart attack, sprained ankle and infections. In many cases, emotional stress also significantly participates in the development of complex regional pain syndrome type II. All these factors are known to cause injury to the nerve of the peripheral nervous system .
The incidence of complex regional pain syndrome type II has been calculated to be 0.8 per 100,000 individuals. The prevalence of the condition is estimated to strike every 4 individuals per 100,000. Statistics have also revealed that, after peripheral nerve injury, the incidence of complex regional pain syndrome II occurs in 1 – 5% of cases  . Females are more prone to develop the disease condition than males.
The exact pathophysiology of complex regional pain syndrome type II is not completely understood. Scientists believe that sensitization of the peripheral and central nerves that occur due to response to tissue injury give rise to the severe pain in the affected arm or leg.
Sensitization of the central nervous system and increase in pain gradually are some of the key points in the onset of complex regional pain syndrome. In addition to this, there is significant evidence of involvement of N-methy-D-aspartate in the sensitization process of the central nervous system. Such sequence of events leads to development of mechanical hyperalgesia, which is characterized by severe pain in the affected limb .
Various steps can be taken for preventing the development of complex regional pain syndrome. Individuals who have suffered wrist fracture are advised to take vitamin C supplements in order to prevent developing the syndrome later in life. It is also necessary that patients who have suffered at attack of stroke should practice early mobilization.
Complex regional pain syndrome type II in the past was also known as causalgia . Significant trauma to a nerve of the peripheral nervous system gives rise to severe pain along with burning sensation in the affected arm or leg. It is a chronic disease condition, which gradually gets more severe as the disease progresses. So far, there is no known cure to the condition; it can however be managed with medications .