What is CRPS?

Complex Regional Pain Syndrome (CRPS) describes a condition in which severe pain affects a limb, often following an injury but sometimes for no obvious reason. It is a condition that can baffle not only those who are experiencing it, but also those they encounter in their daily lives, including many health professionals. This is largely because CRPS causes continuing pain that is usually disproportionate to the severity of the original injury (if there was one) or to the situation in which the pain is triggered. Sometimes, these triggers can be things that we would normally find entirely harmless, such as light touch or vibration. In addition to pain, there may be other symptoms such as colour changes to the affected area, temperature differences compared to the opposite side, swelling, sweating, limitations of movement, or other seemingly bizarre problems.

Diagnosing CRPS can be tricky, as it requires recognition of the pattern of symptoms, while there are no specific tests to confirm the diagnosis. Often, there is a significant delay between onset and diagnosis, on average of about two years. This delay can result in further problems related to function and quality of life. As such, a confirmed diagnosis and subsequent intervention from a specialist multidisciplinary team is essential to enable appropriate management of the condition. Although there is currently no cure for it, for some it can resolve or improve considerably.

What do we do?

We are a national specialist service funded by NHS England, offering intensive rehabilitation for adults with CRPS. The service was set up in 1999 and is one of the few in the UK dedicated to the treatment of CRPS, providing outpatient and inpatient care.

Our service is accessible to adults over the age of 18 with a suspected or confirmed diagnosis of CRPS from a medical doctor.

We offer a specialist interdisciplinary assessment clinic and for those who are appropriate, we provide a two-week bespoke functional rehabilitation programme.

Our Pathway

Referrals

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Multidisciplinary Team Clinic

Depending on the outcome of the triage, the patient may then be invited to attend a Multidisciplinary Team (MDT) clinic. During this clinic, they participate in 3 appointments: one with a pain consultant, one with a senior therapist (occupational therapist or physiotherapist), and one with the health psychologist.

Rehabilitation Programme

If it is appropriate the patient will be invited to participate in our Residential Rehabilitation Programme. This is a two-week, intensive programme that combines specialist physiotherapy, occupational therapy, psychology support, educational sessions, and therapeutic activities.

Follow-ups

Following initial intervention, we provide structured follow-up support to monitor progress and adjust the rehabilitation plan as needed. This includes follow-up with a member of the therapy team, at three, six- and twelve-months post-programme. Additional, ad-hoc follow-ups can be arranged with the therapists depending on the patient's evolving needs.

Open Access (Patient Initiated Follow Up)

After completion of the rehabilitation programme and routine follow-up pathway, the patient may progress to Open Access.

The 12-month Open Access phase of the pathway, designed in line with the self-management ethos of the service, puts the patient in charge of contacting the CRPS team as they feel necessary.

Note for GP and secondary care services:

Please be advised that the Complex Regional Pain Syndrome service is a National tertiary service and we are unable to self-refer under NHS England guidelines.