When you break a wrist, sprain an ankle, or have surgery, you expect pain to fade over time. But what if the pain doesn’t just stick around-it gets worse? What if your skin feels like it’s on fire from the lightest touch, or your hand turns red and swollen for no clear reason? This isn’t normal healing. This could be complex regional pain syndrome-a condition that turns a minor injury into a lifelong battle.

It’s Not Just Pain. It’s a Nervous System Gone Wild

Complex regional pain syndrome, or CRPS, isn’t like a sprained ankle that heals in six weeks. It’s a malfunction in your nervous system. After an injury-sometimes even a small one-the nerves that normally send pain signals start screaming nonstop. Your brain keeps hearing those signals, even when there’s no damage left to fix. The result? Pain that’s way out of proportion to what happened.

People with CRPS often describe it as burning, stabbing, or like electric shocks. It’s not just discomfort. It’s debilitating. One woman in Sydney broke her wrist in a fall. Three months later, her hand was so sensitive that even the brush of her sleeve made her cry. Her skin turned blotchy, felt colder than the other hand, and her fingernails grew faster than normal. She was told it was "just healing." But it wasn’t. It was CRPS.

How Do You Know It’s CRPS and Not Just Slow Healing?

There’s no single blood test or X-ray that confirms CRPS. Doctors diagnose it by what you’re feeling and what they see. The key signs are:

• Pain that’s way worse than the injury should cause
• Changes in skin color-red, purple, pale, or blotchy
• Changes in skin temperature-your hand or foot might feel much hotter or colder than the other side
• Swelling or sweating in the affected area
• Extreme sensitivity to touch, light, or temperature
• Stiff joints, weak muscles, or trouble moving the limb

These symptoms usually show up within weeks after an injury. Most cases appear between four and six weeks later. If you’ve had a fracture, surgery, or even a deep cut-and now your limb feels like it’s on fire-don’t wait. Early recognition is the biggest factor in stopping CRPS from getting worse.

What Triggers CRPS? It’s Not Always What You Think

You might assume CRPS only happens after big injuries. But it doesn’t work that way. About 40% of cases follow a fracture-especially wrist fractures. But it can also start after minor sprains, cuts, or even needle sticks. Surgery isn’t safe either. Knee arthroscopies, carpal tunnel releases, and even dental work have triggered it.

And here’s the twist: in about 10% of cases, there’s no clear injury at all. Someone wakes up with pain they can’t explain. That’s why doctors now say CRPS isn’t just about trauma-it’s about how your nervous system responds to it. Some people’s bodies overreact. Why? No one knows for sure. Genetics might play a role. So might stress, inflammation, or even how your immune system reacts. Studies have found autoantibodies in 30% of CRPS patients, suggesting your own immune system might be attacking your nerves.

Who Gets CRPS? It’s Not Random

CRPS doesn’t pick its victims evenly. Women get it about three times more often than men. It’s most common between ages 40 and 60, but teens and young adults can get it too. If you’ve had CRPS in one limb before, your risk goes up if you’re injured again. And if your pain feels worse than it should, or if your cast feels too tight after an injury-those are red flags.

What’s strange is that two people can break the same bone in the same way, and only one develops CRPS. That’s why researchers are looking at brain patterns, immune markers, and even emotional stress responses. It’s not just physical-it’s neurological, immunological, and psychological.

Stages of CRPS: What Happens Over Time

CRPS doesn’t always follow a clear path, but many people go through phases:

• Stage 1 (0-3 months): Burning pain, swelling, skin changes, increased sweating, faster nail growth, stiffness. The limb might feel warmer or cooler than the other side.
• Stage 2 (3-6 months): Pain gets worse. Skin becomes shiny and thin. Muscles weaken. Joints stiffen. Hair growth slows. The limb feels colder.
• Stage 3 (6+ months): Pain may spread. Muscles shrink. Limb becomes stiff and hard to move. Skin turns pale and tight. This stage can be permanent if not treated early.

Not everyone goes through all three. Some people improve quickly. Others get stuck in stage one for years. The key is catching it before it locks in.

How Is CRPS Treated? It’s Not One-Size-Fits-All

There’s no magic pill for CRPS. But there are proven strategies that work best when started early.

Physical therapy is the most important first step. Moving the limb-even when it hurts-helps reset the nervous system. A physiotherapist who knows CRPS will use gentle, graded movements. Don’t let anyone tell you to rest it. Immobilization makes it worse.

Medications are used to calm the nervous system. NSAIDs help if there’s inflammation early on. Gabapentin or pregabalin target nerve pain. Corticosteroids can reduce swelling in the first few weeks. Antidepressants like amitriptyline or duloxetine are sometimes used, not because it’s "all in your head," but because they help block pain signals.

Nerve blocks can give relief by temporarily shutting down overactive nerves. A sympathetic nerve block involves injecting anesthetic near the spine. If it helps, it confirms CRPS is driving the pain.

Spinal cord stimulation is for long-term cases. A small device is implanted near the spine. It sends mild electrical pulses that distract the brain from the pain signals. Many people get back their quality of life with this.

Ketamine infusions are being tested in clinics. In small doses, ketamine can reset the brain’s pain pathways. It’s not a cure, but for some, it breaks the cycle.

Why Does CRPS Last So Long? The Brain Gets Hooked

Your brain learns pain. If your nerves keep screaming for months, your brain starts believing that pain is normal. It rewires itself to expect it. That’s why CRPS becomes chronic. It’s not just the injury-it’s the brain’s memory of the pain.

This is why psychological support matters. Anxiety and depression don’t cause CRPS, but they make the pain feel worse. Cognitive behavioral therapy (CBT) helps people manage the fear of movement, break the cycle of pain-focused thinking, and regain control.

What’s the Outlook? Hope Isn’t Just a Word

Some people recover fully, especially if treatment starts in the first three months. Others live with pain for years. But that doesn’t mean you’re stuck. New treatments are emerging. Research into autoantibodies, immune modulators, and brain stimulation is opening new doors.

The goal isn’t always total pain elimination. It’s regaining function. Can you hold your coffee? Can you brush your teeth? Can you walk without fear? Those are the real wins.

CRPS is rare. It’s misunderstood. But it’s real. And if you’re living with it, you’re not alone. Thousands of people around the world-many of them women over 40-are fighting the same battle. The key is finding a specialist who knows CRPS isn’t just "chronic pain." It’s a neurological emergency that needs urgent, coordinated care.

What to Do If You Think You Have CRPS

If you’ve had an injury and now your pain doesn’t match the damage:

1. Don’t wait. Go to your doctor within weeks, not months.
2. Describe your pain exactly: burning? electric? sensitive to touch?
3. Ask if it could be CRPS. Mention the Budapest Criteria-doctors need to hear the right terms.
4. Request a referral to a pain specialist or neurologist.
5. Start physical therapy as soon as possible-even if it hurts.
6. Keep a pain diary: note triggers, timing, intensity, and what helps.

You’re not imagining it. You’re not weak. You’re not exaggerating. You’re dealing with a complex neurological condition-and you deserve a diagnosis, not dismissal.