Complex regional pain syndrome

Sunday, July 15, 2018

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WHILE browsing through a British newspaper, I recently came upon an article about a 24-year-old young woman who was suffering from such excruciating pain in her knee that she was begging the doctors to amputate her whole leg.

She was suffering from a rare condition called complex regional pain syndrome (CRPS).

CRPS is a chronic condition that tends to affect an individual limb. It usually occurs after an injury like a sprain, strain, burn, cut or fracture, but some cases arise with no previous history.

It is believed to be caused by damage or malfunction to the peripheral and central nervous system, leading to an exaggerated reaction.

CRPS is characterised by prolonged excessive pain with localised swelling and an increase in temperature of the affected area. It is most commonly found in females up to the age of 40, but is also found in other groups. The pain is neurological, in that there is burning and pins and needles; even the most light touch can cause horrendous pain. CRPS can be hard to diagnose, but is usually based on a patient's medical history and the elimination of other conditions.

Younger people tend to have a better prognosis, but some patients suffer with prolonged, constant pain that even the strongest medication, physical and psychological therapy cannot alleviate.

The young British woman was one such patient as she had suffered from this continuous pain for 10 years. The conclusion to her dilemma was controversial to say the least. After approaching several doctors, all refused to amputate the leg as this went against the standard guidelines for treating CRPS.

She mentioned feeling suicidal and depressed until she found a private surgeon who agreed to carry out the operation. She had an above-knee amputation and she was delighted. The troublesome limb was gone and she could get on with her life.

She was fitted with a very life-like prosthetic limb and had no phantom pain. However, her original general practitioner was frustrated. He understood her desperation but was disappointed that modern medicine could not cure her of what was a relatively normal limb.

Angela Davis BSc (Hons) DPodM MChS is a podiatrist with offices in Montego Bay (293- 7119), Mandeville (962-2100), Ocho Rios (974-6339), Kingston (978-8392), and Savanna-la-Mar (955-3154). She is a member of the Health and Care Professions Council in the United Kingdom.

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