Diagnosed with CRPS? Understanding where your pain is coming from
A complex regional pain syndrome (CRPS) diagnosis can be difficult to make sense of, particularly when your pain is far more severe than you would expect from your original injury.
You may also notice swelling, changes in skin colour or temperature, or pain from something as light as clothing touching your skin.
CRPS is a distinct chronic pain condition involving changes in how the nervous system processes pain. Although symptoms can be intense and difficult to live with, understanding what is happening can provide a starting point for treatment. At Heal & Thrive, I help people learn about their pain and what might support more manageable symptoms and daily function.
What is complex regional pain syndrome?
What are the common symptoms of CRPS?
Why can CRPS pain be so much worse than the original injury?
How does the nervous system maintain CRPS pain?
Why can CRPS be so confusing and isolating?
Can approaches used for other chronic pain conditions help CRPS?
Where do you go from here after a CRPS diagnosis?
Frequently asked questions about complex regional pain syndrome
Understanding complex regional pain syndrome at a glance
CRPS is a distinct chronic pain condition that usually affects a limb and often develops after an injury.
Pain is disproportionate to the original injury and may occur alongside swelling, temperature or colour changes, and sensitivity to touch.
Changes in the peripheral and central nervous systems can contribute to ongoing pain, even when the original injury has healed.
CRPS can be particularly confusing because visible changes may make the affected area look severely injured, even when scans do not explain the level of pain.
Nervous-system-informed approaches used for other chronic pain conditions may also help people with CRPS, alongside condition-specific strategies.
Severe symptoms do not necessarily mean improvement is impossible. Treatment should be tailored to your symptoms, capacity, and goals.
What is complex regional pain syndrome?
Complex regional pain syndrome is a chronic pain condition that usually develops after an injury and affects one limb, although it can spread. Its defining feature is pain that seems more extreme than the original injury would normally cause.
How CRPS differs from other chronic pain conditions
CRPS has specific diagnostic criteria that separate it from conditions such as fibromyalgia, which involves widespread pain, or localised chronic pain such as persistent back pain.
CRPS can develop after an injury that initially appears pretty minor. The pain can continue or worsen beyond what's expected, and symptoms can include changes in the skin, movement, and sensitivity of the affected area.
This doesn’t mean the original injury was insignificant or that the pain is imagined. CRPS involves a real, complex nervous system response.
What are the common symptoms of CRPS?
CRPS can cause severe pain alongside sensory, skin, and movement changes. Symptoms vary between people and may change over time.
Understanding the Budapest Criteria
Clinicians diagnose CRPS using the Budapest Criteria. These include ongoing pain disproportionate to the original event, along with symptoms and signs in different categories.
Common features include:
Sensory changes: Burning pain or extreme sensitivity to light touch
Temperature changes: The affected area may feel unusually warm or cold
Skin colour changes: Skin may appear red, pale, or otherwise different from the unaffected area
Swelling or sweating changes: The affected limb may become swollen or show altered sweating
Movement changes: Reduced range of movement, weakness, or difficulty controlling the affected limb
The National Institute of Neurological Disorders and Stroke’s CRPS information explains that diagnosis is based on symptoms and examination findings, with tests sometimes used to investigate other possible causes.
Why can CRPS pain be so much worse than the original injury?
CRPS pain can continue or become disproportionate because the nervous system changes how it processes and responds to signals from the affected area. Ongoing pain doesn’t necessarily mean the original tissue injury is worsening.
Understanding pain sensitisation
Pain is normally a protective response that helps warn us about potential danger. In CRPS, the pain system can become unusually sensitive, so sensations that would ordinarily be harmless can trigger a strong pain response.
This can involve both:
Peripheral sensitisation: Increased sensitivity in nerves outside the brain and spinal cord
Central sensitisation: Changes in how the brain and spinal cord process and amplify pain signals
These mechanisms can help explain why light touch, movement, or temperature changes can feel extremely painful. They don’t mean the pain is psychological or that the affected area isn’t experiencing real physical changes.
How does the nervous system maintain CRPS pain?
The nervous system can change in response to injury and repeated pain signals. In CRPS, changes in peripheral nerves, the spinal cord, and the brain can contribute to persistent and amplified pain.
When the pain system becomes more efficient at producing pain
I often explain this as an overprotective pain system that’s more practised at producing pain. The nervous system continues responding as though the affected area is under threat, even when the original injury has begun healing.
This helps explain why pain can continue after tissue healing. However, CRPS is complex, and nervous system sensitisation isn’t the only process involved.
The important point is that pain intensity doesn’t always reflect the amount of ongoing tissue damage. Understanding this can help reduce confusion and provide a foundation for exploring treatment.
Why can CRPS be so confusing and isolating?
CRPS can be particularly difficult to understand because the painful area may look visibly abnormal. Redness, swelling, temperature changes, and severe sensitivity can make it look as though something is seriously wrong with the tissues.
When the symptoms look different from the scan
You can have visible changes and intense pain, yet scans or other investigations don’t show any damage to fully explain what you’re experiencing. This can be confusing for you and difficult for others to understand.
CRPS can also be more intense and disruptive than many other chronic pain conditions. Everyday activities like getting dressed, moving the affected limb, or tolerating light touch can become extremely difficult.
I recognise how severe and isolating this can feel. Understanding the role of the nervous system doesn’t minimise the pain or suggest that you should simply be able to ignore it.
Can approaches used for other chronic pain conditions help CRPS?
CRPS is distinct from other chronic pain conditions, but it shares some pain-processing mechanisms with conditions such as fibromyalgia and localised persistent pain. This means some nervous-system-informed approaches might also help people with CRPS.
What I see in practice
In my experience, strategies that support people with broader chronic pain conditions can also help people with CRPS, although the severity and specific symptoms often require more care.
Depending on your needs, treatment may involve:
Pain education: Understanding how pain processing and sensitisation work
Pacing: Finding ways to manage activity without repeatedly aggravating symptoms
Nervous system regulation: Exploring strategies that may help reduce alertness and support symptom stability
Graded Motor Imagery (GMI): Using a structured approach to movement-related brain processing
Desensitisation: Carefully exploring ways to improve tolerance to touch or movement
Medical treatment may also be part of the plan, including medication or other approaches your doctor recommends. The aim is to address the combination of factors contributing to your symptoms rather than relying on one technique.
Where do you go from here after a CRPS diagnosis?
A CRPS diagnosis can feel overwhelming, particularly when your symptoms are severe or have continued longer than expected. However, severity doesn’t necessarily mean that improvement is impossible.
Starting with understanding and support
The first step is to better understand your symptoms, pain, and what you can currently tolerate. From there, treatment can focus on practical strategies that reflect your capacity and goals.
At Heal & Thrive, I begin with a thorough assessment and work with you to identify what might be contributing to your difficulties. We can then explore appropriate pain education, pacing, nervous system regulation, and other strategies without pushing you beyond what you can manage.
The aim isn’t to promise a particular outcome, but to help you find a more manageable way forward and work towards the activities that matter to you.
Frequently asked questions about complex regional pain syndrome
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Yes. CRPS is a distinct chronic pain condition with specific diagnostic criteria. It usually affects a limb and involves pain disproportionate to the original injury, often alongside sensory, skin, or movement changes.
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Yes. CRPS can develop after an injury that initially appears relatively minor. The pain severity can be disproportionate to the original event.
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CRPS can involve increased sensitivity in peripheral nerves and changes in how the brain and spinal cord process pain. These changes can contribute to burning pain and other unusual sensations.
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CRPS can involve changes in blood flow, temperature regulation, and other nervous system processes. These may contribute to redness, temperature differences, swelling, or changes in sweating.
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Yes. Pain can persist after the original injury has healed because changes in the nervous system may continue to trigger pain signals. However, you should still have new or worsening symptoms medically assessed.
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No. CRPS is a distinct condition that usually affects a limb and has specific diagnostic criteria. Fibromyalgia generally involves widespread pain, although both conditions can involve altered pain processing.
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Some people experience meaningful improvement with appropriate treatment and support. Outcomes vary, but severe symptoms don't necessarily mean improvement is impossible.
Find a more manageable way forward with CRPS
CRPS can be an intensely painful and confusing condition, particularly when your symptoms seem out of proportion to the original injury. Understanding how the nervous system contributes to pain can help make sense of your experience and provide a starting point for treatment.
At Heal & Thrive, I provide personalised telehealth support for people living with chronic pain, including CRPS. By considering your symptoms, current capacity, and goals, we can explore nervous-system-informed strategies that support more manageable symptoms and daily function.