Symptoms of Complex Regional Pain Syndrome
- • Pain and swelling in an extremity.
- • Trophic skin changes in the same extremity.
- • Skin atrophy or pigmentary changes.
- • Hypertrichosis.
- • Hyperhidrosis.
- • Nail changes.
- • Signs and symptoms of vasomotor instability.
- • Pain and/or limited motion of the ipsilateral limb including proximal joints (e.g., shoulder–hand syndrome).
- • Neglect-like symptoms concerning the extremity.
- • Motor findings: weakness and limited range of motion (80%), dystonia.
The pain is often described as burning and severe. It generally involves an entire area such as a hand or foot. Allodynia, pain from a usually non-noxious stimulation, such as light touch or even a breeze, is commonly present. Hyperpathia, prolonged pain on stimulation, is also usually present. The vasomotor instability is manifested by a blue and cool area (but occasionally can be warm and erythematous) along with unusual sweating in the area (but occasionally can be dry and scaly). Dystrophic skin changes, such as atrophy of subcutaneous tissue with overlying tight, shiny, hairless skin, may develop later during the evolution of CRPS. Contractures of the flexor surface of the hand may occur in the late stage of this disease, leaving a claw-like, nonfunctional hand.