Complex Regional Pain Syndrome (CRPS), also known as Reflex Sympathetic Dystrophy (RSD), is a chronic nerve condition that causes severe, often debilitating pain. It is widely considered one of the most painful conditions known to medicine. CRPS usually affects an arm, leg, hand, or foot, but it can spread to other parts of the body over time.
CRPS often follows an injury, and in many cases that injury was caused by someone else’s carelessness. If you developed CRPS in California after a car accident, a workplace injury, a fall, or a medical procedure, you may have the right to recover compensation. Doyle APC helps Californians living with CRPS hold the responsible parties accountable.
There are two types of CRPS. Type 1 develops after an injury that did not directly damage a nerve. Type 2 (historically known as causalgia, meaning “burning pain”) involves a confirmed nerve injury. Both cause similar, life-altering symptoms.
Common Causes of CRPS
CRPS almost always begins after some form of trauma to the body. The trauma does not have to be severe. Many cases start with a relatively minor injury such as a sprain or soft-tissue tear. In California, the injuries that most often lead to CRPS include:
Car and motorcycle accidents. Broken bones, crushed limbs, and nerve trauma from collisions on California roads and freeways are a frequent trigger.
Workplace injuries. Falls, machinery accidents, and repetitive trauma on the job can lead to CRPS.
Slips, trips, and falls. A fall on poorly maintained property can fracture a limb or injure a nerve.
Medical procedures. Surgery, blood draws (venipuncture), and IV placement can each cause the kind of trauma that triggers CRPS. Nerve injury is one of the most frequently recognized triggers, so even a routine needle stick that contacts a nerve can be enough.
Because these injuries are so often the result of someone else’s negligence, many people with CRPS have a valid claim for compensation, even when the original injury seemed minor at the time.
Symptoms and How CRPS Progresses
Doctors have traditionally described CRPS as moving through three stages of increasing severity. Many now recognize that the condition does not always follow this fixed sequence, but the stages remain a useful way to understand the range of symptoms a patient may experience.
Stage One (roughly the first one to three months). Burning pain, swelling, and extreme sensitivity to touch (allodynia, meaning pain from a stimulus that would not normally hurt). The affected area often looks red and feels warm, and its temperature and color may change.
Stage Two. Pain and swelling become constant. The skin may take on a bluish tone and feel cool. Patients often notice muscle stiffness, the beginning of muscle wasting, slower hair growth, and brittle nails.
Stage Three. Pain becomes severe and may spread through the limb. There is noticeable muscle wasting, limited movement, and tightening of the muscles and tendons. The skin around the area often looks cool and shiny.
One of the most difficult features of CRPS is that the pain frequently spreads beyond the original injury. The longer treatment is delayed, the more likely it is to spread.
How severe is CRPS pain? Doctors often measure pain using the McGill Pain Index, a scale of 0 to 50. CRPS ranks between 42 and 45, higher than amputation of a finger (40) or childbirth without training (40). For comparison, chronic back pain ranks 27 and a fracture ranks 17. This is why CRPS is described as one of the most painful conditions in medicine.
How CRPS Is Diagnosed
CRPS is notoriously hard to diagnose, and it often goes unrecognized for months or even years. There is no single test that confirms it. Instead, doctors rely on your medical history, a physical examination, and tests that help rule out other conditions or confirm parts of the picture, including:
Nerve conduction studies to check whether the nerves are working normally.
X-rays to look for changes in bone over time.
Bone scans to measure blood flow, which increases in areas affected by CRPS.
Thermography to detect temperature and blood-flow changes in the affected limb.
Doctors also look for the diagnostic criteria set by the International Association for the Study of Pain: an injury or period of immobilization that started the pain, continuing pain that is out of proportion to the injury (including pain from ordinary touch, known as allodynia), visible changes such as swelling, skin color changes, or abnormal sweating, and the absence of any other condition that could explain the symptoms. Some physicians now apply the more rigorous Budapest Criteria, which require the doctor to personally observe objective signs of CRPS rather than relying on the patient’s reported history alone.
The Long Road to a CRPS Diagnosis
For many people, getting a CRPS diagnosis is a frustrating and exhausting process. Because the condition is uncommon and its symptoms overlap with other problems, patients are often told nothing is wrong, or are sent from one doctor to the next for months or even years before anyone names what is happening. In some cases the pain is masked at first by medication given for the original injury, only to return in full force afterward, which delays recognition even more. Some are diagnosed under the older term for the condition, RSD (reflex sympathetic dystrophy), which physicians used for many years.
In our experience, a correct diagnosis often comes only after a patient finally sees a specialist who recognizes the pattern, frequently a pain management specialist or a neurologist. By the time that happens, the window for early treatment has sometimes already closed, which is one of the cruelest features of the condition.
If this sounds familiar, you are not alone. The difficulty of getting diagnosed is one of the reasons CRPS cases call for attorneys who understand the condition and can work with the right medical experts to connect your diagnosis back to the injury that caused it.
Who Develops CRPS
CRPS affects women far more often than men, though doctors do not yet know why. It is most often diagnosed in working-age adults, but it can affect anyone, including children.
Treatment and Prognosis
There is no cure for CRPS. When it is caught early, within a few months of onset, there is a chance the condition will go into remission, although that relief is often temporary. When diagnosis is delayed, the damage can become permanent. This is part of what makes CRPS so devastating: the condition is hard to diagnose, so early treatment is the exception rather than the rule.
Beyond chronic pain, CRPS can cause muscle wasting, problems with blood vessels, and even loss of bone in the affected area. In the most severe cases, the damage can lead to amputation. The constant pain also takes an emotional toll, and many patients are treated for depression and anxiety as a result.
Treatment focuses on managing the pain as much as possible. Doctors usually start with medication and physical therapy, often using pain medication, anti-inflammatory steroids, and antidepressants. When medication is not enough, more involved procedures may be used, including:
Nerve blocks: anesthetic injections that target the sympathetic nerves supplying the affected limb, such as a stellate ganglion block for the arm or hand or a lumbar sympathetic block for the leg.
Ketamine infusions: medication delivered intravenously to interrupt the pain signaling that drives CRPS, used increasingly when other measures are not enough.
Internal pain pumps: an implanted device that delivers pain medication directly to the spinal column, where it works far more effectively than pills.
Spinal cord stimulators: an implanted device that sends mild electrical signals to the spinal cord to interrupt pain signals before they reach the brain.
Surgical sympathectomy: a last-resort surgery that cuts the nerves carrying pain signals to the affected area.
Because of how much care CRPS requires, treatment can be extraordinarily expensive and usually continues for the rest of a patient’s life.
CRPS Injury Claims in California
If a third party caused the injury that led to your CRPS, you may be entitled to compensation. Because CRPS usually requires a lifetime of treatment and often makes it impossible to keep working, the financial stakes in these cases are high. Depending on your situation, a California CRPS claim may seek:
Medical expenses, past, present, and future, which are often substantial.
Lost wages, past and future, since many people with CRPS can no longer work.
Life care planning costs, a detailed projection of the future medical and personal care you will need.
Pain and suffering, reflecting both the pain you have already endured and the pain you are expected to live with.
Lost earning capacity, the reduction in your ability to earn income over your lifetime.
Not every type of compensation applies to every case, and the value of a claim depends on its specific facts.
California deadlines are strict. In general, California gives injured people two years from the date of injury to file a personal injury lawsuit, but important exceptions apply. Claims involving medical providers or government entities can carry shorter deadlines and special notice requirements, and the timeline can be complicated when a CRPS diagnosis comes long after the original injury. Because waiting too long can permanently bar your claim, it is important to speak with an attorney as soon as possible. This information is general and is not legal advice about your individual situation.
Doyle APC understands how completely CRPS can change a person’s life and the lives of their family. The firm’s attorneys bring more than 28 years of experience holding negligent companies and individuals accountable for the harm they cause. To talk through your situation and whether you may have a claim, complete our contact form for a free case review or call (619) 736-0000. Doyle APC handles CRPS cases on a contingency-fee basis, which means you owe no attorney’s fees unless the firm recovers compensation for you.
Get a Free Case EvaluationIf you or a family member has symptoms of CRPS, see a physician as soon as possible. Because CRPS is so difficult to diagnose, consider seeing a specialist who has experience with the condition, such as a pain management specialist or neurologist.