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If your CRPS diagnosis was more than a decade ago, it wouldn’t surprise me if you encountered significant scepticism among medical professionals. Whilst this attitude hasn’t vanished entirely, clinicians generally now better understand the condition. Back then, on reviewing medical records, I would regularly encounter references to:
- ‘illness behaviour’;
- ‘somatisation’;
- ‘hypochondriasis’; and
- ‘illness anxiety disorder’.
On one occasion, a client was wrongly diagnosed with ‘Munchausen syndrome’! Incredibly, these tags were often applied in the face of abundantly clear signs and symptoms of CRPS.
What causes CRPS?
Although the mechanism isn’t entirely understood, it’s now accepted that CRPS occurs due to dysfunction in your central or peripheral nervous systems, usually the result of trauma. So, CRPS is a neurological condition.
CRPS and psychological symptoms
CRPS impacts every aspect of daily life. It’s not surprising then that for most people, the condition triggers psychological symptoms. Many develop stress, anxiety, or depression. And it’s not unusual for partners and other family members to describe a personality change. Certainly, most people require specific psychological treatment at some point following a diagnosis of CRPS. Typically, that might include:
- antidepressant medication;
- cognitive behavioural therapy (CBT); or
- eye movement desensitisation and reprocessing (EMDR).
However, another significant problem is that the psychological symptoms triggered by living with CRPS, in turn, serve to exacerbate the pain and dysfunction associated with the condition. So, there begins a downward spiral where the CRPS symptoms trigger psychological symptoms, which in turn exacerbate the CRPS symptoms, exacerbating the psychological symptoms, etc.
That’s why the effective management of CRPS involves addressing every aspect of a person’s condition in a multidisciplinary approach. Accordingly, in a pain clinic setting, a typical treatment plan includes input from various clinicians, including:
- pain doctors;
- psychologists;
- physiotherapists; and
- occupational therapists.
CRPS and PTSD
Occasionally, CRPS can lead to Post-Traumatic Stress Disorder (PTSD). Indeed, a study published in 2017 demonstrated that PTSD occurs more frequently in people with CRPS than in the general population. In other words, PTSD is a risk factor for people with CRPS.
Addressing the psychological impact of pain in your compensation claim
For all of the above reasons, in a compensation claim involving CRPS, it’s crucial to consider the psychological impact of pain. In most cases, that involves obtaining the expert opinion of a psychiatrist (as opposed to a psychologist) with a special interest in chronic pain. Unfortunately, they are relatively few and far between, so waiting lists (even privately) can be lengthy. But as with any expert evidence, instructing the right expert is key to the claim’s success.