What are the symptoms of complex regional pain syndrome (CRPS)?

The symptoms of CRPS vary in severity and how long they last. Symptoms usually begin within one month after an injury or after having to stay in bed for a long time. The main symptom is pain in the arm or leg, which is often burning, sharp, stabbing or stinging. There may also be tingling and numbness.

The symptoms are usually much worse than you would expect from the injury. CRPS pain continues after the original injury has healed. The symptoms are often severe and have a big effect on day-to-day activities. The pain may spread to other limbs. The pain is constant and can become worse rather than better with time. Staying in bed and not moving around makes the pain and stiffness worse.

Movement may be limited, both because of the pain and because joints can feel stiff. The muscles may become weak. Other muscle problems may occur and include sudden and severe spasms, tremors, severe jerking and other abnormal movements.

The pain and other symptoms often spread up the arm or leg from the site of the original injury. The symptoms may suddenly affect the opposite limb.

Many patients say that their limb ‘feels strange’. It can feel as if it does not belong to the rest of the body and as if it is not your own limb. Sometimes the limb feels bigger or smaller than normal.

As well as pain, the affected area may have other symptoms such as:

• Skin sensitivity: the skin may become oversensitive to light touch.
• Allodynia: this means that you feel pain even after just a gentle touch, such as clothes brushing your skin or even air blowing on your skin. This may be felt as severe pain.
• Swelling: may occur over the painful region.
• Temperature differences between opposite sides: the affected arm or leg may often be warmer or cooler and the temperature may keep changing.
• Abnormal sweating.
• Skin changes:
  • Abnormal skin changes may occur, like ‘goosebumps’ and skin rashes.
  • There may be changes in the skin colour of the affected limb.
  • Skin infections can occur and can be very severe.
  • Your skin may become shiny, dry or scaly.
• Hair changes: hair may become coarse but then become thin.
• Fingernail or toenail changes: nails in the affected area may become brittle (crumbly or break easily) and grow faster at the beginning and then slower.

Psychological symptoms

Psychological symptoms may include:

• Difficulty relaxing.
• Feeling less confident in yourself.
• Feeling unable to cope.
• Difficulty getting or accepting support from friends or family.

Depression (this is common).