Complex Regional Pain Syndrome (CRPS) In the Foot: Causes, Symptoms, and Treatment

Complex regional pain syndrome (CRPS) is a medical condition characterized by severe pain, swelling, and skin changes. This condition can affect any part of the human body, but it usually affects the extremities – arms, hands, legs, or feet. CRPS that affects a foot is called CRPS in the foot.

Causes of CRPS in the Foot

The cause of CRPS in the foot (or any other body part) is not clearly understood, but it typically develops after a surgery, injury, heart attack, infection, or stroke. CRPS may also occur after limb immobilization due to an accident, breast cancer, or degenerative arthritis.

If CRPS occurs after a distinctive injury to a nerve, it is called Type II CRPS, formerly known as causalgia. On the other hand, Type I CRPS, previously called reflex sympathetic dystrophy (RSD), occurs when there is no confirmed nerve damage. Nevertheless, the term RSD is usually used to describe the symptoms associated with either type of CRPS.

Symptoms of CRPS in the Foot

The most distinctive symptom of CRPS is severe pain that is disproportionate to the medical condition or initial injury causing it. The intensity of CRPS symptoms varies among individuals. Typically, CRPS in the foot follows three stages of development. They are:

Stage One

This initial stage of CRPS in the foot lasts between one to three months. During this time, people usually experience severe burning or pain in the affected limb, muscle tremors, swelling, and rapid hair and nail growth.

The skin around the affected limb usually changes in texture, appearing thinner, shinier, or tender. Also, a person may experience skin color changes (blue, red, or pale), skin temperature changes (cold or sweaty), and sensitivity to touch and temperature.

Stage Two

After time passes, stage one CRPS symptoms could progress to stage two. Stage two CRPS of the foot usually lasts three to six months. During this phase, the muscles weaken, and the joints around the affected foot stiffen and swell.

Also, the pain intensity on the affected foot increases and may spread throughout the limb or to the other foot. The skin continues changing, and the nails become hard and easily cracked. Hair growth on the affected foot usually slows down during this stage.

Stage Three

This is the chronic stage of CRPS in the foot. It usually starts about one year after the onset of the CRPS and may last for several years. In some cases, stage three CRPS causes permanent changes in the foot.

During this stage, atrophy can develop in the affected foot (and limb), leading to a loss of function. Also, the skin becomes pale, cool, dry, and shiny. The pain intensity may remain constant or become intermittent.

Treatment of CRPS in the Foot

Although mild cases of CRPS in the foot recover on their own, it’s best to initiate treatment as early as possible and address the origin of the pain instead of the symptoms.

Here are some common CRPS treatments available today.

Vagus Nerve Stimulation

According to The Spero Clinic, a neurologic relief center, ”Symptom numbing is an ineffective and short-term solution. Treatment for CRPS in the foot should be approached holistically to get to the root cause of the pain rather than just treating the symptoms.”

So, for true healing, your doctor will not only figure out why you got sick but also why your body is not able to heal itself.

Physical Therapy

Physical therapy is crucial in CRPS treatment to maintain mobility, strength, and flexibility in the affected limb and improve blood flow. It also helps prevent brain and spinal cord changes associated with chronic pain and limb disuse.

Psychotherapy

Psychotherapy helps address the secondary psychological problems that a person may develop due to CRPS, such as anxiety, post-traumatic stress disorder, and depression. These problems can decrease brain function and activity, making it difficult for patients to embrace rehabilitation. With psychological therapy, a person with CRPS in the foot can feel better and recover faster.

Medications

When given early, medication can effectively treat CRPS symptoms in the foot. Some classes of drugs used for treating CRPS are acetaminophen, corticosteroids, opioids, topical anesthetic ointments, and non-steroidal anti-inflammatory drugs (NSAIDs) like naproxen and ibuprofen. Nevertheless, it’s crucial to note that no single medication or combination is guaranteed to be effective in treating CRPS for all patients.

Spinal Cord Stimulation

Stimulating electrodes are implanted in the spine outside a patient’s spinal cord and turned on to create tingling sensations in the affected limb. This helps to normalize signaling in the brain and spinal cord and block pain sensations.