Complex regional pain syndrome (CRPS) explained

What CRPS is

CRPS is a long-lasting pain condition that usually affects one limb, often after an injury such as a fracture, sprain, operation or even a minor knock. The striking feature is that the pain is out of proportion to the original injury and lasts far longer than expected. It is thought to involve the nerves and the way the brain and nervous system process pain signals, so that the system becomes over-sensitive. It is not "all in the mind", and it is not something a person is imagining or exaggerating — it is a real, recognised condition. The exact cause is not fully understood, which can make it frustrating to live with and to explain to family, friends or employers.

Recognising the symptoms

The main symptom is continuous, often burning or throbbing pain in the affected limb. The area can become so sensitive that even a light touch, clothing or a breeze feels painful. Alongside the pain, people often notice changes in the skin: it may look shiny, mottled, red or blotchy, and feel warmer or cooler than the other limb. There is often swelling, and the skin, hair and nails may change in texture or growth. The limb can feel stiff, weak or difficult to move, and some people find it hard to use it normally. Symptoms may spread or vary from day to day, which can be confusing and worrying if you do not know what is happening.

How CRPS is diagnosed

There is no single test that confirms CRPS. Instead, doctors make the diagnosis by listening carefully to your symptoms and examining the limb, looking for the typical pattern of pain, skin, temperature and swelling changes, and ruling out other conditions that could explain them. This is why diagnosis can sometimes take time. You may be referred to a specialist, such as a pain clinic or a rehabilitation team, particularly if symptoms are severe or not improving. Getting the right diagnosis matters, because it opens the door to the specific kinds of treatment and support that help CRPS, and because being believed and understood is itself an important step for many people living with the condition.

Treatment and management

CRPS is usually managed by a team rather than a single treatment. Physiotherapy and keeping the limb moving, even gently, are central, because avoiding using it altogether can make stiffness and sensitivity worse over time. Techniques to gradually get the limb used to touch and movement are often part of this. Medicines may be used to help with nerve-type pain, and specialist pain services can offer additional options. Psychological support is not because the pain is imagined, but because living with constant pain is genuinely hard, and learning ways to cope can improve day-to-day life. Because CRPS varies so much between people, treatment is tailored to the individual, and early, active management tends to give the best results.

Living with CRPS and looking ahead

The outlook in CRPS varies widely. Some people improve significantly, especially with early treatment, while others live with longer-term symptoms that need ongoing management. Pacing activities, staying as active as your limb allows, and keeping in touch with your care team all help. Practical support — at work, at home and emotionally — can make a real difference, and patient organisations offer information and a sense of community with others who understand. If your symptoms change, worsen or spread, tell your team so your treatment can be reviewed. While CRPS can be a difficult condition, understanding it and working actively with specialists gives the best chance of keeping the limb useful and improving quality of life.