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CRPS, Complex Regional Pain Syndrome is a progressive disease of the sympathetic nervous system. This poorly understood condition is commonly described by a collection of clinical symptoms and signs occurring throughout the body. They start to appear after one or more traumas (injuries, accidents, surgeries, stress) and progress into chronic neuropathic pain that is generally out of proportion to the degree of the original trauma. Pain is the main problem of CRPS but symptoms are numerous and can involve broad regions of the body unassociated with the trauma.
Identifying and treating CRPS in TMJ patients is a relatively a new practice in dentistry but the connection cannot be denied in some cases where the patient’s chronic pain condition goes beyond the primary pain source in the TMJ.
The hallmark signs of Facial CRPS include:
• Numbness, tingling, burning sensations
• Swelling and edema in the cheeks
• Red, white or blue skin discoloration
• Skin irritations, rash or an unusually smooth skin appearance
• Reduced mobility, stiffness and limited range of motion in the lower jaw
• An increase or decrease in skin temperature
• Hypersensitivity to cold with exposure exacerbating the pain
• Heightened pain to a very light touch
• Drooping eyelid
• Teeth are cold and sensitive
• Tightness or spasms in the facial muscles
• Increased pain in the TMJ when the joint is in movement or not engaged
There is no cure for CRPS but if diagnosed in its early stages, patients can achieve long periods of remission. The key is to treat the primary source of pain in the TMJ and CRPS concurrently because the pain in one will exacerbate the pain in the other.
Treatments for controlling CRPS include:
• Regional nerve block injections to shut down the sympathetic system in order to decrease the pain source. Dr. Rosser administers these in the comfort of his office and patients often have immediate results.
• Prescribing neuropathic medication
• Appropriate physical therapy Learn more: Recommended Epsom Salt Baths for CRPS
• A recommended CRPS diet Learn more: CRPS Diet Recommendations
It is estimated that there between 1.5 and 3 million people in the United States suffering from this invisible disease. Early recognition of the signs and symptoms of CRPS as well as early treatment are usually effective in preventing it from becoming a chronic condition. Although Dr. Rosser is specifically addressing Facial CRPS in conjunction with TMJ treatment, it should be noted that if you are diagnosed with CRPS, that primary treatment should be administered by a qualified physician experienced in working with CRPS patients.