Complex Regional Pain Syndrome
What is CRPS & How Can It Affect Veterans
Complex Regional Pain Syndrome (CRPS) is a chronic pain condition that usually affects one limb, typically after an injury or trauma. In many veterans, CRPS may occur as a result of Non-Freezing Cold Injury (NFCI), though its exact cause can vary.
Key Symptoms of CRPS
- Allodynia – pain from something that normally doesn’t cause pain, like a light touch.
- Hyperalgesia – heightened sensitivity to pain.
- Skin and tissue changes can include swelling, colour changes, sweating, and changes to hair or nail growth.
- Movement difficulties – Many individuals experience stiffness or limited range of motion.
At Veterans Welfare Group, we understand the profound impact CRPS can have on day-to-day life. Our role is to provide clear, practical support and resources for veterans managing this condition.
Understanding the Causes
CRPS is a complex condition with no single known cause. Instead, it’s believed to result from a combination of nervous system dysfunction, inflammation, and sometimes psychological stress. For many veterans, CRPS may develop following Non-Freezing Cold Injury or trauma to a limb, even when that trauma seems minor.
Contributing Factors in CRPS
- Nervous system sensitivity – The peripheral and central nervous systems may overreact to injury, leading to exaggerated pain signals.
- Inflammation – Localised inflammation plays a significant role, especially early on.
- Vascular changes – Changes in blood flow may affect tissue health and contribute to symptoms like swelling or skin discolouration.
- Genetic and psychological components – Some individuals may be predisposed due to genetics or stress-related factors.
Our Approach to CRPS Recovery
At Veterans Welfare Group, we take an interdisciplinary approach to managing CRPS. This means addressing the condition from all angles — physical, emotional, and functional — because effective recovery requires a holistic approach to pain relief.
Core Principles of Our Support Strategy
- Early intervention – Addressing CRPS early increases the chances of recovery.
- Function first – Restoring the ability to move and perform daily activities is central.
- Steady pacing – Avoiding overuse and complete rest is critical.
- Biopsychosocial support – We consider the physical body, mental well-being, and social environment equally.
Recovery Framework Overview
Focus Area | Description |
Physical Activity | Gentle, progressive exercise to reduce pain and improve function |
Pain Education | Understanding pain helps reduce fear and build confidence |
Desensitisation | Gradual reintroduction to touch and movement to calm the nervous system |
Psychosocial Care | Stress management and psychological support where needed |
Team Involvement | Collaboration with physios, OTs, psychologists, and peer support services |
We support each veteran’s recovery process by adapting to individual needs, because no two CRPS cases are exactly alike.
Physiotherapy Techniques That Help
Physiotherapy is a vital part of CRPS management. It involves retraining the body and nervous system through carefully guided movements and strategies that support recovery without triggering setbacks.
Technique | Purpose |
Mirror Visual Feedback | Improves brain-body connection and reduces pain perception |
Tactile Sensory Discrimination | Re-teaches the nervous system to interpret touch appropriately |
Strength Progression | Builds tolerance through isometrics to resistance-based movements |
Pain Neuroscience Education | Explains pain mechanisms to reduce fear and improve participation |
Hydrotherapy | Low-impact, supportive movement that encourages mobility and strength |
Physiotherapists avoid aggressive techniques, prolonged rest, or ice therapy, as these can worsen symptoms. Instead, the focus is on sustainable progression and building trust between the patient and their body.
Occupational Therapy in CRPS
Occupational Therapy (OT) is critical in helping individuals return to everyday activities safely, confidently, and with reduced discomfort. For veterans with CRPS, the goal of OT is to promote independence through practical strategies and graded re-engagement with tasks.
Key Occupational Therapy Strategies for CRPS Management
- Desensitisation: Gradually reintroducing textures and pressures to help normalise touch sensitivity.
- Stress Loading: Carefully applying weight-bearing tasks (e.g. carrying light items) to encourage joint and nerve adaptation.
- Splinting (if required): Occasionally used to support circulation and positioning, but monitored closely to avoid overuse.
- Edema Management: Using compression and manual techniques to reduce swelling.
Mental Health & Pain Psychology
While CRPS is a physical condition, psychological support is an essential part of managing it effectively. Chronic pain can be emotionally draining, and for many veterans, there’s a need to address trauma, frustration, and the fear that comes with ongoing discomfort.
Psychological Interventions That Support Healing
- Cognitive Behavioural Therapy (CBT): Helps address kinesiophobia (fear of movement), catastrophic thinking, and emotional patterns that worsen pain.
- Graded Exposure: A psychological and physical strategy to help patients re-engage with movements and situations they’ve come to fear.
- ACT (Acceptance and Commitment Therapy): Encourages veterans to accept pain as part of their experience while committing to meaningful activities.
- Mindfulness & Stress Management: Techniques like breathing exercises can help lower stress-related pain flare-ups by reducing nervous system overactivity.
Conclusion
Our veteran recovery specialists understand that living with CRPS can be overwhelming, especially when symptoms persist without clear answers. Our approach is centred on realistic recovery, functional improvement, and ongoing support through physiotherapy, occupational therapy, and mental health strategies.
Whether you’re just starting your journey or looking for practical ways to manage your condition, we’re here to help at every step.
United Kingdom (UK) Defence Statistics indicated that 301 British veterans sustained an amputation through service in Iraq or Afghanistan up to 31st March 2023.
The lifelong impact of traumatic limb-loss is also particularly relevant for older veterans who served in (among others) the Second World War, Korea, Northern Ireland, Vietnam and the Falklands, and whose health issues may be exacerbated by age-related changes and comorbidities, including the long-term psychological consequences of war.
Treatment under Military guidance, such as that at Stanford Hall varies considerably to what is offered via the NHS Limb Centres. There are 35 centres in England that provide specialized prosthetic services. These are consultant-led services and they involve a specialised multi-disciplinary team, which includes, for example; prosthetist; occupational therapist; physiotherapist; podiatrist; and psychologist.
If you have had an amputation and are registered with a GP, you will be eligible to attend an NHS Limb Centre where your mobility needs will be assessed. You may need a prosthetic limb or wheelchair. This will be provided free of charge where applicable, based on clinical need. Your GP or hospital that carried out the surgery will refer you to the appropriate Limb Centre.
If you lost a limb in Service, you can access the veterans’ prosthetics programme. This programme has enabled nine Disablement Service Centres (DSC’s) in England to offer enhanced services to veterans, accessed by referral from the veterans own GP
British Limbless Ex-Servicemen’s Association (BLESMA) is a national service charity that supports limbless veterans since injury for the remainder of their life.