CRPS: When Pain Becomes a Disease
/By Madora Pennington
For Pattie Christensen, Complex Regional Pain Syndrome (CRPS) started after she had surgery for carpal tunnel syndrome in 2022. She opted for a local anesthetic, since it was a simple procedure.
Everything seemed fine until a month passed after her second hand surgery. Christensen felt something was wrong — very wrong. The outside of her hand started to hurt terribly. When she talked to her surgeon, he pointed out that the area now hurting had not even been involved in the surgery. The region that was operated on had healed well.
Things got worse. Soon her hand swelled to where her fingers looked like raw, discolored sausage. That’s when she got the bad news: Christensen had CRPS, a debilitating chronic pain condition that can be ignited by a simple fracture, sprain, surgery, or even a cardiovascular event.
CRPS causes dysfunction and confusion in the nervous system, amping up pain in an injured area. The pain then migrates to other nerves in non-injured areas. Most commonly, the CRPS pain settles and remains in a hand. Early treatment is the best chance to stop the progression of CRPS, but for many it becomes a long-term or even lifelong problem.
Christensen now makes videos about her life with CRPS on YouTube from her home in Salt Lake City, runs a Facebook support group, and tries to remain optimistic. Unfortunately, like most people with CRPS, she suffers from migraines.
According to a new study of 88 patients with CRPS in Australia, two out of three started having migraines or a worsening of their migraines after CRPS took hold.
“We found that migraine headaches often began or got worse after the injury that triggered CRPS. There seemed to be a direct connection between the limb injury and the headaches as they were often on the same side of the body and symptoms overlapped. That is, one condition may feed the other,” says lead author Peter Drummond, PhD, a Psychology Professor at Murdoch University.
“Unfortunately, many people with CRPS face the prospect of enduring a lifetime of pain because understanding is poor and treatment options are limited.”
One in every five people in the study has headaches almost every day, something Christensen can relate to.
“I never know if I’m going to have a bad migraine,” she says.
One of her migraine relief medications costs Christensen $150 per pill. She only takes that when it gets very bad.
She describes a recent episode: “I had dry heaves. I was crying.” She started with half of her expensive pills and felt nothing. It took $300 of medication and a period of lying down to get any relief. “I can’t say I felt great, I just felt okay and was able to work.”
CRPS is a disease of pain signaling gone wrong. People with CRPS tend to have extreme light sensitivity, foreheads painful to touch, and hyperalgesia (feeling pain from non-painful stimuli).
In the Australian study, participants with worse limb pain and hyperalgesia were more headache-prone. And the patients who were younger when their pain started were more likely to end up with headaches.
“We hope that greater recognition of the link between CRPS and migraine will clarify understanding of both conditions and will result in more effective treatment of headaches and a better quality of life for people with CRPS,” says Drummond.
CRPS seems to result from an overactive inflammatory response in the brain and spinal cord (neuroinflammation), a hyperactive nervous system (central sensitization), and problems with the body’s natural pain dampening signals.
Researchers say this heightened pain feedback creates a positive loop where pain increases. The mechanisms behind migraines and CRPS, both quite disabling on their own, fuel each other.
Those who never had migraines before the start of CRPS are likely to get them. And those who already had migraines will get more of them. Although it may sound like it, CRPS is not psychosomatic. There are very real internal body processes that have gone wrong.
