When pain in an injured arm or leg stays intense after a crash
A pain medicine physician and a physical therapist look at possible complex regional pain syndrome
After a broken bone or another arm or leg injury, pain usually shifts as you heal. Sometimes it stays unusually intense or spreads. Ask a doctor to look at it if that happens. That’s especially true if the area is sensitive to touch, swollen, or changing in skin color or temperature. [1]
One possible cause is complex regional pain syndrome, known as CRPS. A list of symptoms alone can’t diagnose it. A pain specialist studies the pattern and checks for other causes. A physical therapist helps you get back to using the limb safely. [1]
Keep a clear record of the pain
Write down where the pain started and where it is now. Note any sensitivity to touch, swelling, sweating or stiffness. Also note changes in color or temperature, and any changes in your hair or nails. If visible changes come and go, take photos and date them. Tell your care team what you can no longer do, like putting on a shoe or using a hand. Ask whether the injury, a nerve problem, an infection, a clot or some other condition could explain it. [1]
Build a recovery plan with your care team
If your care team suspects CRPS, ask for a plan that pairs the right pain treatment with gradual rehab. Therapy may work on movement, lowering touch sensitivity and handling everyday tasks. Your care team should help you set the pace. [1]
Avoid forcing a very painful movement over and over. Also avoid keeping the limb still with no end date unless your team advises it. Mental health support can help with the distress and poor sleep that lasting pain can bring. [1]
Know which changes can't wait
An arm or leg that suddenly turns cold or pale needs urgent care. So do new weakness, a fever or a wound that is quickly getting worse. Do not write off a new emergency as CRPS. If the pain lingers but holds steady, get it checked early. Don’t wait months to bring it up. Treatment often works better when it starts early. [1]
Questions for your next appointment
- What other causes of my symptoms should be checked?
- What plan for movement and sensitivity is safe with my injury?
- Who will track my progress and change my treatment?
Bring a week of notes to your visit
Keep a record of your symptoms for one week. Take it to your next injury visit along with any dated photos. Ask whether a referral to a pain or rehab specialist makes sense for you. [1]
Sources and further reading
General information from the fields of pain medicine and physical therapy. Several different problems can cause these symptoms. New severe pain or changes in blood flow must be checked by a medical professional.
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